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Individual

JUSTIN M PAGAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S., M.S.D.

Contact information

Practice address
21807 76TH AVE W, EDMONDS, WA 98026-7938
(425) 775-3564
Mailing address
21807 76TH AVE W, EDMONDS, WA 98026-7938
(425) 775-3564

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DE00010404
WA

Other

Enumeration date
10/11/2006
Last updated
07/08/2007
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