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General NPI Number Information
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NPI Number | 1063659852
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Entity Type | Organization
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Legal Business Name | JOSEPH R. PELUSO
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Dates
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Enumeration Date | 01/15/2009
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Last Update Date | 01/15/2009
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Provider Practice Location Address
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Address Line | 115 MAIN ST
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City | NORTH EASTON
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State | MA
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Zip | 02356-1468
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Country | US
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Telephone | 508-238-1119
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Fax | 508-238-2448
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Provider Business Mailing Address
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Address Line | 115 MAIN STREET
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City | NORTH EASTON
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State | MA
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Zip | 02356
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Country | US
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Telephone | 508-238-1119
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Fax | 508-238-2448
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. STEPHANIE ANN SAVOY
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Credential |
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Telephone | 508-238-1119
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 12537
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License Number State | MA
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