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Individual

ANIT MERRY MATHEW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
14410 SE PETROVITSKY RD, #113, RENTON, WA 98058
(626) 253-1734
Mailing address
14410 SE PETROVITSKY RD, #113, RENTON, WA 98058
(626) 253-1734

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE60573228
WA

Other

Enumeration date
07/20/2012
Last updated
05/31/2016
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