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General NPI Number Information
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NPI Number | 1306034285
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Entity Type | Organization
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Legal Business Name | ORAL SURGERY OFFICE, INC.
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Dates
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Enumeration Date | 10/04/2007
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Last Update Date | 08/27/2008
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Provider Practice Location Address
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Address Line | 730 SUNRISE AVE SUITE 130
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City | ROSEVILLE
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State | CA
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Zip | 95661-4567
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Country | US
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Telephone | 916-782-2161
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Fax | 916-782-0677
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Provider Business Mailing Address
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Address Line | 730 SUNRISE AVE SUITE 130
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City | ROSEVILLE
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State | CA
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Zip | 95661-4567
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Country | US
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Telephone | 916-782-2161
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Fax | 916-782-0677
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MRS. TIFFANY SETTLE
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Credential |
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Telephone | 916-487-5152
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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 | 91830
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License Number State | CA
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