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NPI 1508952466

NPI 1508952466 : STEVEN JOSEPH EDWARDS DDS : SAN CLEMENTE, CA

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General NPI Number Information
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    NPI Number           |    1508952466
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    Entity Type          |    Individual 
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    Provider Name        |    STEVEN JOSEPH EDWARDS DDS
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    10/05/2006
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    Last Update Date     |    10/18/2011
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Provider Practice Location Address
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    Address Line         |    1151 PUERTA DEL SOL SUITE A
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    City                 |    SAN CLEMENTE
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    State                |    CA
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    Zip                  |    92673-6311
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    Country              |    US
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    Telephone            |    949-369-8300
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    Fax                  |    949-369-8308
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Provider Business Mailing Address
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    Address Line         |    26 CHAMONIX 
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    City                 |    LAGUNA NIGUEL
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    State                |    CA
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    Zip                  |    92677-8904
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    Country              |    US
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    Telephone            |    949-584-0954
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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       |    34482
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    License Number State |    CA
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