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Individual
DR. MICHELLE LYNN CANNON
Active
Individual
DR. MICHELLE LYNN CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
019.028140
IL
1223G0001X
General Practice Dentistry
Primary
12011767A
IN
Other
Enumeration date
11/05/2009
Last updated
05/10/2012
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