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General NPI Number Information
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NPI Number | 1235158825
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Entity Type | Individual
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Provider Name | JOHJANNIESMAGNO GRIFFITH DMD
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Gender | Male
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 08/26/2015
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Provider Practice Location Address
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Address Line | E3 CARR 155 URBANISACION BRAZILIA
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City | VEGA BAJA
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State | PR
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Zip | 00693-4673
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Country | US
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Telephone | 787-858-5060
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Fax | 787-784-2427
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Provider Business Mailing Address
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Address Line | PO BOX 56015
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City | BAYAMON
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State | PR
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Zip | 00960-6215
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Country | US
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Telephone | 787-858-5060
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Fax | 787-784-2427
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 1216
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License Number State | PR
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