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General NPI Number Information
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NPI Number | 1023354370
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Entity Type | Organization
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Legal Business Name | MARK DANKOWSKI, DMD PC
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Dates
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Enumeration Date | 12/13/2012
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Last Update Date | 12/13/2012
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Provider Practice Location Address
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Address Line | 8080 UTAH ST
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City | MERRILLVILLE
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State | IN
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Zip | 46410-6502
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Country | US
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Telephone | 219-947-2581
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Fax | 219-947-4636
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Provider Business Mailing Address
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Address Line | 8080 UTAH ST
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City | MERRILLVILLE
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State | IN
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Zip | 46410-6502
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Country | US
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Telephone | 219-947-2581
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Fax | 219-947-4636
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARK DANKOWSKI
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Credential | DMD
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Telephone | 219-947-2581
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 12010869A
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License Number State | IN
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