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General NPI Number Information
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NPI Number | 1013096767
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Entity Type | Organization
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Legal Business Name | DENTAL & FAMILY MEDICAL CENTER
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Dates
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Enumeration Date | 11/03/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1507 DEKALB AVE
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City | BROOKLYN
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State | NY
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Zip | 11237-3634
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Country | US
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Telephone | 718-417-4769
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Fax |
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Provider Business Mailing Address
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Address Line | 76 SUNNYSIDE LN
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City | WESTBURY
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State | NY
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Zip | 11590-2823
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Country | US
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Telephone | 516-338-1701
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Fax |
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Authorized Official
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Title or Position | PEDIATRICIAN
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Name | DR. JEAN E. RAMEAU
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Credential | MD
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Telephone | 718-417-1469
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 192901
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License Number State | NY
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