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General NPI Number Information
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NPI Number | 1063681989
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Entity Type | Organization
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Legal Business Name | ANDREW BERMAN, DDS, INC
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Dates
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Enumeration Date | 02/25/2008
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Last Update Date | 02/25/2008
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Provider Practice Location Address
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Address Line | 911 E AURORA RD
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City | MACEDONIA
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State | OH
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Zip | 44056-1905
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Country | US
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Telephone | 330-467-1800
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Fax | 330-467-1811
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Provider Business Mailing Address
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Address Line | 911 E AURORA RD
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City | MACEDONIA
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State | OH
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Zip | 44056-1905
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Country | US
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Telephone | 330-467-1800
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Fax | 330-467-1811
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. FANNY B LYONS
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Credential |
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Telephone | 330-467-1800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 16381
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License Number State | OH
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