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General NPI Number Information
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NPI Number | 1164935060
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Entity Type | Organization
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Legal Business Name | ENSURE DENTAL CARE PLLC
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Dates
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Enumeration Date | 11/14/2017
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Last Update Date | 11/14/2017
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Provider Practice Location Address
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Address Line | 520 S SAGINAW BLVD
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City | SAGINAW
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State | TX
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Zip | 76179-1906
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Country | US
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Telephone | 682-710-1812
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Fax |
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Provider Business Mailing Address
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Address Line | 9519 VISTA CIR
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City | IRVING
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State | TX
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Zip | 75063-5065
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Country | US
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Telephone | 630-780-7948
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | RASHI VINAYAK MUTHAL
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Credential |
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Telephone | 682-710-1812
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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 | 29858
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License Number State | TX
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