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General NPI Number Information
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NPI Number | 1467518597
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Entity Type | Individual
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Provider Name | JEFFREY MICHAEL ROSEN D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/01/2007
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Last Update Date | 07/19/2013
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Provider Practice Location Address
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Address Line | 3131 COLLEGE HEIGHTS BLVD SUITE 2100
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City | ALLENTOWN
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State | PA
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Zip | 18104-4812
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Country | US
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Telephone | 610-434-4077
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Fax |
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Provider Business Mailing Address
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Address Line | 3131 COLLEGE HEIGHTS BLVD SUITE 2100
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City | ALLENTOWN
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State | PA
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Zip | 18104-4812
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Country | US
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Telephone | 610-434-4077
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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 | DS020244-L
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License Number State | PA
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