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Individual
PRIYA BANAHATTI
Active
Individual
PRIYA BANAHATTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901018573
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4554740
—
MI
Enumeration date
07/03/2006
Last updated
07/27/2011
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