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General NPI Number Information
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NPI Number | 1255060794
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Entity Type | Organization
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Legal Business Name | THAAR ALDOURI DDS INC
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Dates
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Enumeration Date | 06/09/2022
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Last Update Date | 09/03/2022
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Provider Practice Location Address
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Address Line | 520 E FOOTHILL BLVD STE B
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City | POMONA
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State | CA
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Zip | 91767-1200
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Country | US
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Telephone | 909-624-1781
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Fax |
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Provider Business Mailing Address
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Address Line | 3310 COBBLESTONE
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City | LA VERNE
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State | CA
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Zip | 91750-3611
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Country | US
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Telephone | 909-372-9676
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | THAAR ALDOURI
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Credential |
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Telephone | 909-372-9676
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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 |
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License Number State |
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