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General NPI Number Information
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NPI Number | 1073497111
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Entity Type | Organization
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Legal Business Name | DELL DENTAL CORPORATION
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Dates
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Enumeration Date | 08/01/2025
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 1127 WILSHIRE BLVD STE 404
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City | LOS ANGELES
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State | CA
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Zip | 90017-3905
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Country | US
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Telephone | 213-423-1127
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Fax |
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Provider Business Mailing Address
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Address Line | 6699 ALVARADO RD STE 2202
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City | SAN DIEGO
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State | CA
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Zip | 92120-5293
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Country | US
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Telephone | 619-302-3804
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Fax |
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Authorized Official
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Title or Position | SECRETARY
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Name | PAULO DOS SANTOS
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Credential |
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Telephone | 619-302-3804
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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 |
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License Number State |
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