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General NPI Number Information
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NPI Number | 1174771406
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Entity Type | Individual
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Provider Name | DANIEL CLAYTON GIOIA DDS
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Gender | Male
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Dates
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Enumeration Date | 08/28/2008
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Last Update Date | 08/28/2008
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Provider Practice Location Address
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Address Line | 316 MAIN ST PHS INDIAN HOSPITAL
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City | EAGLE BUTTE
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State | SD
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Zip | 57625-0590
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Country | US
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Telephone | 605-964-7830
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 590
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City | EAGLE BUTTE
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State | SD
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Zip | 57625-0590
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Country | US
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Telephone | 605-964-7830
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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 | 14996
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License Number State | MO
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