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General NPI Number Information
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NPI Number | 1518152875
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Entity Type | Individual
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Provider Name | MATTHEW E NELSON DDS
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Gender | Male
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Dates
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Enumeration Date | 09/10/2007
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Last Update Date | 05/22/2009
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Provider Practice Location Address
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Address Line | 7101 E THOMAS RD
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-6336
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Country | US
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Telephone | 480-947-3004
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Fax |
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Provider Business Mailing Address
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Address Line | 39625 N BELFAIR WAY
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City | ANTHEM
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State | AZ
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Zip | 85086-3662
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Country | US
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Telephone | 623-215-4468
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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 | 5519
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License Number State | NV
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