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General NPI Number Information
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NPI Number | 1376262907
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Entity Type | Individual
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Provider Name | PAULA DANELLE GRIECO
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Gender | Female
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Dates
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Enumeration Date | 08/25/2022
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Last Update Date | 08/25/2022
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Provider Practice Location Address
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Address Line | 1315 SHAW AVE
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City | CLOVIS
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State | CA
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Zip | 93612-3961
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Country | US
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Telephone | 559-321-0886
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Fax | 559-547-3194
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Provider Business Mailing Address
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Address Line | 1758 N BUNDY AVE
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City | CLOVIS
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State | CA
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Zip | 93619-8151
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Country | US
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Telephone | 559-283-5001
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 913
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License Number State | CA
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