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General NPI Number Information
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NPI Number | 1063674653
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Entity Type | Individual
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Provider Name | MICHAEL CHAU DMD
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Gender | Male
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Dates
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Enumeration Date | 06/25/2008
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Last Update Date | 03/23/2023
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Provider Practice Location Address
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Address Line | 603 GREENWICH ST STE 1B
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City | NEW YORK
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State | NY
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Zip | 10014-7073
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Country | US
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Telephone | 212-352-9300
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Fax |
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Provider Business Mailing Address
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Address Line | 22 MYRTLE AVE
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City | EDGEWATER
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State | NJ
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Zip | 07020-1405
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Country | US
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Telephone | 973-229-8846
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 053976
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License Number State | NY
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