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General NPI Number Information
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NPI Number | 1366627572
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Entity Type | Individual
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Provider Name | SAMUEL C ROXAS DMD
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Gender | Male
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Dates
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Enumeration Date | 01/07/2008
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Last Update Date | 01/07/2008
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Provider Practice Location Address
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Address Line | 3130 W 6TH ST STE 1
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City | LOS ANGELES
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State | CA
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Zip | 90020-1702
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Country | US
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Telephone | 213-382-5650
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Fax | 213-382-1443
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Provider Business Mailing Address
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Address Line | 3130 W 6TH ST STE 1
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City | LOS ANGELES
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State | CA
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Zip | 90020-1702
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Country | US
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Telephone | 213-382-5650
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Fax | 213-382-1443
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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 | 41532
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License Number State | CA
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