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NPI 1053623942

NPI 1053623942 : SARA NATASHA JEFFREY DMD : BOSTON, MA

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General NPI Number Information
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    NPI Number           |    1053623942
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    Entity Type          |    Individual 
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    Provider Name        |    SARA NATASHA JEFFREY DMD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/08/2010
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    Last Update Date     |    07/08/2010
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Provider Practice Location Address
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    Address Line         |    100 E NEWTON ST 
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    City                 |    BOSTON
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    State                |    MA
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    Zip                  |    02118-2308
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    Country              |    US
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    Telephone            |    617-638-4787
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    259 WASHINGTON ST 
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    City                 |    CAMBRIDGE
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    State                |    MA
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    Zip                  |    02139-3503
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    Country              |    US
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    Telephone            |    617-971-7399
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    Fax                  |    
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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       |    DL10959
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    License Number State |    MA
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