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Individual

DR. STEPHEN JAMES MANGAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
1625 E LAS OLAS BLVD, FORT LAUDERDALE, FL 33301-2357
(954) 463-5051
Mailing address
1111 SE 5TH CT, FORT LAUDERDALE, FL 33301-3005
(954) 655-0251

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
DN18777
FL

Other

Enumeration date
03/11/2010
Last updated
03/11/2010
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