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NPI 1093890857

NPI 1093890857 : ANTHONY Q NGO DMD : HENDERSON, NV

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General NPI Number Information
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    NPI Number           |    1093890857
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    Entity Type          |    Individual 
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    Provider Name        |    ANTHONY Q NGO DMD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    10/27/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    4300 E SUNSET RD #B2
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    City                 |    HENDERSON
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    State                |    NV
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    Zip                  |    89014
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    Country              |    US
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    Telephone            |    702-968-0707
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    Fax                  |    702-968-0708
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Provider Business Mailing Address
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    Address Line         |    6040 S RAINBOW BLVD #2
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    City                 |    LAS VEGAS
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    State                |    NV
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    Zip                  |    89118
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    Country              |    US
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    Telephone            |    702-880-4266
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    Fax                  |    702-792-4266
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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       |    4063
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    License Number State |    NV
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