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NPI 1457562555

NPI 1457562555 : SEAN P GAFFNEY DDS : JEFFERSON, LA

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General NPI Number Information
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    NPI Number           |    1457562555
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    Entity Type          |    Individual 
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    Provider Name        |    SEAN P GAFFNEY DDS
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/24/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    825 S CLEARVIEW PKWY 
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    City                 |    JEFFERSON
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    State                |    LA
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    Zip                  |    70121-3119
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    Country              |    US
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    Telephone            |    504-733-1135
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 1257 
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    City                 |    KENNER
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    State                |    LA
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    Zip                  |    70063-1257
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    Country              |    US
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    Telephone            |    504-733-1135
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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       |    5564
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    License Number State |    LA
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