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Individual
ISSA S SASA
Active
Individual
ISSA S SASA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BDS, MS, FRCD (C)
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
F23030
TX
Other
Enumeration date
06/05/2008
Last updated
08/04/2008
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