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Individual

DR. CAMILO MACHADO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS, MS

Contact information

Practice address
31315 HARPER AVENUW, ST. CLAIR SHORES, MI 48082
(586) 293-3434
(586) 293-4460
Mailing address
31315 HARPER AVENUE, ST. CLAIR SHORES, MI 48082
(586) 293-3434
(614) 292-9422

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1710025499
MI
1223P0700X
Prosthodontics
71-000189
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
71000189
OHIO STATE LICENSE NUMBER
OH
Enumeration date
02/02/2007
Last updated
11/19/2021
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