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1013391721
SEVERINO JOSE MATA MATA
FARMINGTON, CT
NPI
1013391721
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2015-07-13
Last Update Date
2015-07-13
Business Address
Dr. SEVERINO JOSE MATA MATA D.D.S.
263 FARMINGTON AVE
FARMINGTON, CT 06030-0001
Phone number: 860-679-2000
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Mailing Address
Dr. SEVERINO JOSE MATA MATA D.D.S.
55 BRITTANY FARMS RD APT 213
NEW BRITAIN, CT 06053-1203
Phone number: 860-970-6580
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