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General NPI Number Information
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NPI Number | 1306962725
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Entity Type | Individual
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Provider Name | SALVATORE SERIFINO SELVAGGIO D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3601 CONNECTICUT AVE NW
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City | WASHINGTON
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State | DC
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Zip | 20008-2406
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Country | US
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Telephone | 202-362-5596
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Fax | 202-362-7191
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Provider Business Mailing Address
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Address Line | 3724 WARREN ST NW
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City | WASHINGTON
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State | DC
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Zip | 20016-2233
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Country | US
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Telephone | 202-362-0571
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Fax | 201-362-7191
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DEN3615
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License Number State | DC
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