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Individual

DR. CONNIE SUAH SHIM MIDDLETON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.D.S

Contact information

Practice address
1234 E DUPONT RD STE 4, FORT WAYNE, IN 46825-1545
(260) 490-3495
(260) 497-0540
Mailing address
1234 E DUPONT RD STE 4, FORT WAYNE, IN 46825-1545
(260) 490-3495
(260) 497-0540

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12011842A
IN

Other

Enumeration date
07/03/2012
Last updated
07/03/2012
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