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General NPI Number Information
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NPI Number | 1407443229
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Entity Type | Organization
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Legal Business Name | SUJAY TRIVEDI DMD PA
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Dates
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Enumeration Date | 12/28/2020
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Last Update Date | 12/28/2020
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Provider Practice Location Address
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Address Line | 3111 45TH ST STE 7
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City | WEST PALM BEACH
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State | FL
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Zip | 33407-1981
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Country | US
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Telephone | 561-687-0006
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Fax |
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Provider Business Mailing Address
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Address Line | 275 N FEDERAL HWY APT 113
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City | POMPANO BEACH
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State | FL
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Zip | 33062-4344
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Country | US
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Telephone | 860-805-8875
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SUJAY TRIVEDI
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Credential | DMD
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Telephone | 860-805-8875
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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 |
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License Number State |
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