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NPI 1265532840

NPI 1265532840 : NORMAN DABIRI D.M.D. : CHICAGO, IL

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General NPI Number Information
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    NPI Number           |    1265532840
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    Entity Type          |    Individual 
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    Provider Name        |    NORMAN DABIRI D.M.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/24/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    6449 S PULASKI RD 
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    City                 |    CHICAGO
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    State                |    IL
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    Zip                  |    60629-5148
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    Country              |    US
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    Telephone            |    773-581-8185
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 6015 
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    City                 |    CHICAGO
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    State                |    IL
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    Zip                  |    60680-6015
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    Country              |    US
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    Telephone            |    773-581-8185
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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        |    1223G0001X
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    Taxonomy Name        |    General Practice Dentistry
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    License Number       |    
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    License Number State |    IL
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