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Individual
YUAN TIAN
Active
Individual
YUAN TIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS041929
PA
1223G0001X
General Practice Dentistry
060095
NY
Other
Enumeration date
05/05/2017
Last updated
04/15/2023
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