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NPI 1033242979

NPI 1033242979 : VINCENT KARL TROSSELLO D.M.D.,M.SC.D. : QUINCY, MA

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General NPI Number Information
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    NPI Number           |    1033242979
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    Entity Type          |    Individual 
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    Provider Name        |    VINCENT KARL TROSSELLO D.M.D.,M.SC.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/13/2007
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    Last Update Date     |    09/11/2025
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Provider Practice Location Address
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    Address Line         |    165 WASHINGTON ST 
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    City                 |    QUINCY
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    State                |    MA
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    Zip                  |    02169-5514
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    Country              |    US
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    Telephone            |    617-471-1890
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    Fax                  |    617-471-7310
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Provider Business Mailing Address
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    Address Line         |    165 WASHINGTON ST 
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    City                 |    QUINCY
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    State                |    MA
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    Zip                  |    02169-5514
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    Country              |    US
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    Telephone            |    617-471-1890
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    Fax                  |    617-471-7310
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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       |    12314
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    License Number State |    MA
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Taxonomy #2
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    Taxonomy Code        |    1223P0700X
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    Taxonomy Name        |    Prosthodontics
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    License Number       |    12314
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    License Number State |    MA
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Taxonomy #3
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    Taxonomy Code        |    1223X0400X
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    Taxonomy Name        |    Orthodontics and Dentofacial Orthopedics Dentistry
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    License Number       |    12314
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    License Number State |    MA
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