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General NPI Number Information
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NPI Number | 1356525943
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Entity Type | Individual
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Provider Name | PEDRO M SOTO DDM
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Gender | Male
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Dates
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Enumeration Date | 12/19/2007
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Last Update Date | 12/19/2007
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Provider Practice Location Address
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Address Line | 4996 1/2 W ROGERS BLVD
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City | SKIATOOK
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State | OK
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Zip | 74070
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Country | US
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Telephone | 918-396-4002
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Fax | 918-396-4002
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Provider Business Mailing Address
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Address Line | PO BOX 724
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City | SKIATOOK
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State | OK
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Zip | 74070-0724
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Country | US
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Telephone | 918-396-4002
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Fax | 918-396-4002
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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 | 122400000X
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Taxonomy Name | Denturist
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License Number | 1042
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License Number State | OK
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