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General NPI Number Information
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NPI Number | 1164611901
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Entity Type | Individual
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Provider Name | WILLIAM A. FOSTER JR. LICENSED DENTURIST
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Gender | Male
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Dates
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Enumeration Date | 10/17/2007
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Last Update Date | 02/25/2021
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Provider Practice Location Address
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Address Line | 524 LAUREL ST
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City | FLORENCE
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State | OR
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Zip | 97439-9359
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Country | US
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Telephone | 541-997-6054
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Fax | 541-997-6054
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Provider Business Mailing Address
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Address Line | PO BOX 1078
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City | FLORENCE
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State | OR
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Zip | 97439-0051
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Country | US
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Telephone | 541-997-6054
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Fax | 541-997-6054
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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 | 122400000X
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Taxonomy Name | Denturist
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License Number | 536084
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License Number State | OR
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