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General NPI Number Information
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NPI Number | 1184198061
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Entity Type | Individual
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Provider Name | ANMOLJIT KAUR SANDHU RDH
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Gender | Female
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Dates
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Enumeration Date | 01/14/2019
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Last Update Date | 01/14/2019
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Provider Practice Location Address
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Address Line | 1010 SHAW AVE STE B
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City | CLOVIS
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State | CA
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Zip | 93612-3950
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Country | US
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Telephone | 559-777-6113
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Fax | 559-323-4301
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Provider Business Mailing Address
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Address Line | 2399 MEGAN AVE
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City | CLOVIS
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State | CA
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Zip | 93611-5081
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Country | US
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Telephone | 559-309-3352
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 21841
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License Number State | CA
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