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General NPI Number Information
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NPI Number | 1376540450
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Entity Type | Individual
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Provider Name | SCOTT D. BENJAMIN D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 07/05/2005
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Last Update Date | 06/22/2010
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Provider Practice Location Address
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Address Line | 60 UNION ST
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City | SIDNEY
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State | NY
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Zip | 13838-1430
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Country | US
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Telephone | 607-563-2333
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Fax | 607-563-8946
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Provider Business Mailing Address
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Address Line | 1863 CRYSTAL LAKE RD
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City | HANCOCK
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State | NY
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Zip | 13783-1915
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Country | US
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Telephone | 607-467-4456
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Fax | 607-467-5634
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 033878
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License Number State | NY
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