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Individual
DR. JEREMY ALFRED
Active
Individual
DR. JEREMY ALFRED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
34132
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34132
DENTAL LICENSE
TX
Enumeration date
08/24/2018
Last updated
08/24/2018
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