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Individual

DR. AMI ROXANA MATA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
1212 N JOSEY LN STE 238, CARROLLTON, TX 75006-6104
(972) 418-8461
Mailing address
2027 LEATH ST, DALLAS, TX 75212-1743
(214) 755-5046

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
37421
TX

Other

Enumeration date
07/08/2021
Last updated
07/08/2021
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