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Individual

DEBORAH BENNETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
104 SANDSTONE BEND LN, DICKINSON, TX 77539-4445
(409) 771-3622
Mailing address
104 SANDSTONE BEND LN, DICKINSON, TX 77539-4445
(409) 771-3622

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
102495
TX

Other

Enumeration date
04/03/2014
Last updated
04/03/2014
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