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NPI 1396897682

NPI 1396897682 : WILLIAM J HEFELE D.D.S. : ASHLAND, VA

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General NPI Number Information
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    NPI Number           |    1396897682
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    Entity Type          |    Individual 
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    Provider Name        |    WILLIAM J HEFELE D.D.S.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    01/17/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    200 VIRGINIA ST 
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    City                 |    ASHLAND
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    State                |    VA
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    Zip                  |    23005-2049
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    Country              |    US
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    Telephone            |    804-798-8019
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    Fax                  |    804-798-1320
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Provider Business Mailing Address
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    Address Line         |    200 VIRGINIA ST 
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    City                 |    ASHLAND
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    State                |    VA
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    Zip                  |    23005-2049
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    Country              |    US
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    Telephone            |    804-798-8019
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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        |    1223G0001X
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    Taxonomy Name        |    General Practice Dentistry
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    License Number       |    0401007474
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    License Number State |    VA
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