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NPI 1174634844

NPI 1174634844 : WESTMORELAND DENTAL APPLIANCES INC : SCOTTDALE, PA

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General NPI Number Information
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    NPI Number           |    1174634844
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    Entity Type          |    Organization 
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    Legal Business Name  |    WESTMORELAND DENTAL APPLIANCES INC 
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Dates
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    Enumeration Date     |    08/31/2006
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    Last Update Date     |    06/05/2008
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Provider Practice Location Address
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    Address Line         |    111 CROSSROADS ROAD 
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    City                 |    SCOTTDALE
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    State                |    PA
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    Zip                  |    15683
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    Country              |    US
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    Telephone            |    724-887-3060
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    Fax                  |    724-887-3945
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Provider Business Mailing Address
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    Address Line         |    111 CROSSROADS ROAD 
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    City                 |    SCOTTDALE
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    State                |    PA
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    Zip                  |    15683
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    Country              |    US
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    Telephone            |    724-887-3060
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    Fax                  |    724-887-3945
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |    DR. JAMES EUGENE NICOLETTE 
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    Credential           |    DMD
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    Telephone            |    724-887-3060
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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       |    014087
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    License Number State |    PA
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