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Individual

AMPARO BARRAGON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DENTAL HYGIENIST

Contact information

Practice address
1454 MADISON AVE W, IMMOKALEE, FL 34142-2200
(239) 658-3000
(239) 658-3091
Mailing address
12420 CROOKED CREEK LN, FORT MYERS, FL 33913-6729
(239) 658-3000
(239) 658-3091

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH20255
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DH20255
STATE LICENSE
FL
Enumeration date
10/10/2016
Last updated
10/10/2016
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