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General NPI Number Information
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NPI Number | 1184308116
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Entity Type | Organization
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Legal Business Name | WEIDENFELD ENDODONTICS PLLC
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Dates
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Enumeration Date | 06/12/2023
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Last Update Date | 06/12/2023
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Provider Practice Location Address
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Address Line | 207 ROUTE 32
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City | CENTRAL VALLEY
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State | NY
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Zip | 10917-3607
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Country | US
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Telephone | 845-928-5275
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Fax |
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Provider Business Mailing Address
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Address Line | 207 ROUTE 32
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City | CENTRAL VALLEY
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State | NY
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Zip | 10917-3607
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Country | US
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Telephone | 845-928-5275
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALEX WEIDENFELD
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Credential | DMD
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Telephone | 845-928-5275
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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