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Individual
GREGORY DEAN MITCHELL
Active
Individual
GREGORY DEAN MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
32490
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32490
STATE LICENSE
CA
Enumeration date
09/04/2008
Last updated
09/04/2008
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