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General NPI Number Information
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NPI Number | 1023175924
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Entity Type | Individual
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Provider Name | JEFFREY J SANTANELLO DMD
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Gender | Male
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 11/01/2011
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Provider Practice Location Address
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Address Line | 1700 HORIZON DRIVE SUITE 101
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City | CHALFONT
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State | PA
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Zip | 18914-3950
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Country | US
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Telephone | 215-997-0740
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Fax | 215-997-0743
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Provider Business Mailing Address
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Address Line | 1700 HORIZON DRIVE SUITE 101
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City | CHALFONT
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State | PA
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Zip | 18914-3950
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Country | US
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Telephone | 215-997-0740
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Fax | 215-997-0743
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0401411462
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License Number State | VA
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