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Individual
LEKEBA TIER GRANGER
Active
Individual
LEKEBA TIER GRANGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
32403
TX
1223G0001X
General Practice Dentistry
019028548
IL
Other
Enumeration date
01/21/2011
Last updated
12/08/2016
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