Individual
DR. TARA KHAMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
100221
CA
1223G0001X
General Practice Dentistry
RES.004134
OH
Other
Enumeration date
07/06/2016
Last updated
06/15/2019
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