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General NPI Number Information
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NPI Number | 1124482682
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Entity Type | Individual
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Provider Name | GABRIELLE CRUZ AQUINO DMD
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Gender | Female
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Dates
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Enumeration Date | 04/11/2016
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Last Update Date | 02/01/2025
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Provider Practice Location Address
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Address Line | 8710 W CHARLESTON BLVD STE 100
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City | LAS VEGAS
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State | NV
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Zip | 89117-5467
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Country | US
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Telephone | 702-330-8952
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Fax |
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Provider Business Mailing Address
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Address Line | 8370 W CHEYENNE AVE STE 103
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City | LAS VEGAS
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State | NV
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Zip | 89129-2174
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Country | US
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Telephone | 702-843-5141
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | S6-211
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License Number State | NV
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