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General NPI Number Information
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NPI Number | 1245445717
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Entity Type | Organization
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Legal Business Name | PATIENT 1ST DENTAL CARE
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 350 5TH AVE. SUITE 2618
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City | NEW YORK
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State | NY
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Zip | 10118
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Country | US
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Telephone | 917-609-8555
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Fax | 732-381-2997
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Provider Business Mailing Address
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Address Line | 2293 ST. GEORGES AVE.
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City | RAHWAY
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State | NJ
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Zip | 07065
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Country | US
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Telephone | 917-609-8555
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RAMONCITO C BENITO
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Credential | DDS
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Telephone | 917-609-8555
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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 | 048645-1
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License Number State | NY
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