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NPI 1114936838

NPI 1114936838 : FREDERICK WILLIAM DENIKE DMD : EMERSON, NJ

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General NPI Number Information
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    NPI Number           |    1114936838
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    Entity Type          |    Individual 
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    Provider Name        |    FREDERICK WILLIAM DENIKE DMD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/05/2006
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    Last Update Date     |    05/01/2020
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Provider Practice Location Address
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    Address Line         |    24 EMERSON PLAZA WEST 
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    City                 |    EMERSON
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    State                |    NJ
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    Zip                  |    07630
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    Country              |    US
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    Telephone            |    201-599-0001
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    Fax                  |    201-599-0992
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Provider Business Mailing Address
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    Address Line         |    24 EMERSON PLAZA WEST 
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    City                 |    EMERSON
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    State                |    NJ
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    Zip                  |    07630
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    Country              |    US
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    Telephone            |    201-599-0001
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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        |    1223G0001X
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    Taxonomy Name        |    General Practice Dentistry
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    License Number       |    D13380
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    License Number State |    NJ
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