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General NPI Number Information
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NPI Number | 1437378528
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Entity Type | Individual
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Provider Name | VICTOR M. GOMES DMD
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Gender | Male
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 30 FERRY ST
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City | NEWARK
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State | NJ
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Zip | 07105-1438
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Country | US
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Telephone | 973-589-0177
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Fax | 973-589-0177
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Provider Business Mailing Address
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Address Line | 703 ROEMER AVE
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City | TEANECK
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State | NJ
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Zip | 07666-2257
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Country | US
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Telephone | 201-836-0342
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DI17895
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License Number State | NJ
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