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General NPI Number Information
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NPI Number | 1376893792
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Entity Type | Organization
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Legal Business Name | MARIA CASTANEDA DMD PL
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Dates
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Enumeration Date | 09/13/2012
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Last Update Date | 09/13/2012
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Provider Practice Location Address
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Address Line | 16850 JOG RD SUITE 114N
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City | DELRAY BEACH
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State | FL
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Zip | 33446-2383
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Country | US
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Telephone | 561-509-7460
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Fax |
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Provider Business Mailing Address
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Address Line | 16850 JOG RD SUITE 114N
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City | DELRAY BEACH
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State | FL
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Zip | 33446-2383
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Country | US
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Telephone | 561-509-7460
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARIA CASTANEDA
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Credential | DMD
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Telephone | 786-266-0677
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | DN16679
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License Number State | FL
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