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Individual
DR. KRISTEN MULLINS DOUGLAS
Active
Individual
DR. KRISTEN MULLINS DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
3847-16
MS
1223P0221X
Pediatric Dentistry
10230
TN
1223P0221X
Pediatric Dentistry
Primary
PEDO-534-17
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04203063
—
MS
Enumeration date
05/13/2014
Last updated
03/28/2018
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