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General NPI Number Information
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NPI Number | 1053584607
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Entity Type | Organization
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Legal Business Name | GALANDENTALPC
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Dates
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Enumeration Date | 04/03/2008
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Last Update Date | 04/03/2008
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Provider Practice Location Address
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Address Line | 3440 BROADWAY APT 1A
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City | NEW YORK
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State | NY
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Zip | 10031-5609
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Country | US
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Telephone | 212-283-6555
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Fax | 212-283-1211
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Provider Business Mailing Address
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Address Line | 3440 BROADWAY APT 1A
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City | NEW YORK
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State | NY
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Zip | 10031-5609
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Country | US
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Telephone | 212-283-6555
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Fax | 212-283-1211
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Authorized Official
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Title or Position | DENTIST
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Name | DR. MANUEL F GALAN JR.
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Credential | DDS
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Telephone | 212-283-6555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | 046680-1
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License Number State | NY
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