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Individual
DR. MATTHEW ENNS
Active
Individual
DR. MATTHEW ENNS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
101260
CA
122300000X
Dentist
DN1856836
MA
Other
Enumeration date
07/02/2015
Last updated
04/27/2017
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