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General NPI Number Information
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NPI Number | 1215500988
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Entity Type | Individual
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Provider Name | SHREYA MOHAN DMD
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Gender | Female
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Dates
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Enumeration Date | 07/21/2021
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Last Update Date | 12/11/2023
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Provider Practice Location Address
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Address Line | 1 RIVER PL BLDG C
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City | LOWELL
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State | MA
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Zip | 01852-1035
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Country | US
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Telephone | 978-458-1114
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Fax |
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Provider Business Mailing Address
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Address Line | 255 NORTH RD UNIT 22
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City | CHELMSFORD
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State | MA
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Zip | 01824-1405
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Country | US
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Telephone | 978-319-0262
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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 | DN1859103
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License Number State | MA
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