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General NPI Number Information
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NPI Number | 1467761775
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Entity Type | Organization
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Legal Business Name | PERFECT SMILE DENTAL CENTER
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Dates
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Enumeration Date | 10/04/2010
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Last Update Date | 10/04/2010
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Provider Practice Location Address
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Address Line | 615 PIIKOI ST SUITE 1806
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City | HONOLULU
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State | HI
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Zip | 96814-3116
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Country | US
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Telephone | 808-596-4434
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Fax | 808-597-1619
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Provider Business Mailing Address
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Address Line | 615 PIIKOI ST SUITE 1806
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City | HONOLULU
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State | HI
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Zip | 96814-3116
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Country | US
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Telephone | 808-596-4434
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Fax | 808-597-1619
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARICRIS HERNANDEZ MACAPAGAL
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Credential | DDS
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Telephone | 808-596-4434
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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 | DT2002
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License Number State | HI
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