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Individual
MARY KOURAKIN
Active
Individual
MARY KOURAKIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
22HI00343600
NJ
Other
Enumeration date
10/27/2014
Last updated
10/27/2014
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