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1487389581
AUTUMN TATMAN
CHAMPAIGN, IL
NPI
1487389581
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
124Q00000X Dental Hygienist
(Licence: IL 020.015266)
Enumeration Date
2022-07-21
Last Update Date
2022-07-21
Business Address
AUTUMN TATMAN
201 W KENYON RD
CHAMPAIGN, IL 61820-7892
Phone number: 217-531-4279
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Mailing Address
AUTUMN TATMAN
201 W KENYON RD
CHAMPAIGN, IL 61820-7892
Phone number:
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