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General NPI Number Information
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NPI Number | 1245629666
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Entity Type | Organization
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Legal Business Name | PETER M SINCLAIR, DDS A PROFESSIONAL DENTAL CORPOR
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Dates
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Enumeration Date | 01/22/2015
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Last Update Date | 03/05/2015
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Provider Practice Location Address
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Address Line | 23451 MADISON ST SUITE 130
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City | TORRANCE
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State | CA
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Zip | 90505-4763
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Country | US
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Telephone | 310-375-0001
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Fax | 310-373-8405
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Provider Business Mailing Address
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Address Line | 23451 MADISON ST SUITE 130
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City | TORRANCE
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State | CA
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Zip | 90505-4763
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Country | US
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Telephone | 310-375-0001
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Fax | 310-373-8405
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Authorized Official
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Title or Position | FINANCIAL COORDINATOR
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Name | SANDRA LORENZANA
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Credential |
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Telephone | 310-375-0001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 42884
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License Number State | CA
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