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General NPI Number Information
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NPI Number | 1023280229
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Entity Type | Individual
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Provider Name | MAYANK R ADATIA D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 03/27/2008
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Last Update Date | 03/27/2008
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Provider Practice Location Address
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Address Line | 853 N HIGHLAND AVE SUITE C
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City | AURORA
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State | IL
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Zip | 60506-2217
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Country | US
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Telephone | 630-844-3368
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Fax | 630-844-2873
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Provider Business Mailing Address
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Address Line | 1013 SHEPPEY CT
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City | NAPERVILLE
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State | IL
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Zip | 60565-6109
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Country | US
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Telephone | 847-769-4132
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Fax | 847-310-6796
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State | IL
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