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General NPI Number Information
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NPI Number | 1134416118
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Entity Type | Organization
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Legal Business Name | ROSARIO SALERNO DENTAL CARE LLC
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Dates
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Enumeration Date | 06/29/2011
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Last Update Date | 04/23/2020
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Provider Practice Location Address
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Address Line | 1N121 COUNTY FARM RD STE 130
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City | WINFIELD
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State | IL
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Zip | 60190-2034
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Country | US
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Telephone | 847-334-9652
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Fax |
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Provider Business Mailing Address
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Address Line | 2972 ANDRUS DR
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City | WEST CHICAGO
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State | IL
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Zip | 60185-5211
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Country | US
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Telephone | 847-334-9652
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Fax |
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Authorized Official
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Title or Position | DENTIST/PRESIDENT
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Name | DR. ROSARIO DEFATIMA SALERNO
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Credential | D.D.S
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Telephone | 847-334-9652
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 019025191
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License Number State | IL
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