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General NPI Number Information
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NPI Number | 1326171430
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Entity Type | Individual
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Provider Name | JARRED EVAN SEID DDS
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Gender | Male
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 176 NORTH VILLAGE AVE 2F
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City | ROCKVILLE CENTRE
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State | NY
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Zip | 11570
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Country | US
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Telephone | 516-594-3300
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Fax |
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Provider Business Mailing Address
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Address Line | 8 BARSTOW RD APT 7E
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City | GREAT NECK
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State | NY
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Zip | 11021-3543
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Country | US
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Telephone | 516-984-6989
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 048667
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License Number State | NY
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