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General NPI Number Information
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NPI Number | 1164781662
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Entity Type | Individual
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Provider Name | JOSE ADALBERTO RIOS LOAIZA D.D.S
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Gender | Male
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Dates
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Enumeration Date | 05/04/2012
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Last Update Date | 01/28/2015
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Provider Practice Location Address
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Address Line | 201 N EUCLID ST
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City | FULLERTON
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State | CA
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Zip | 92832-1620
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Country | US
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Telephone | 714-578-6768
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Fax |
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Provider Business Mailing Address
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Address Line | 201 N. EUCLID ST.
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City | FULLERTON
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State | CA
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Zip | 92832
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Country | US
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Telephone | 714-578-6768
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 61286
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License Number State | CA
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