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PABLO DE OLIVEIRA BAUTISTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
795 E WINCHESTER ST, MURRAY, UT 84107-7564
(801) 630-8811
(435) 296-8497
Mailing address
795 E WINCHESTER ST, MURRAY, UT 84107-7564
(801) 630-8811
(435) 397-6406

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11264147-9923
UT
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
07/15/2017
Last updated
04/29/2026
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