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General NPI Number Information
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NPI Number | 1518631753
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Entity Type | Organization
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Legal Business Name | MOUNTAIN AND RIVER DENTAL AND ASSOCIATES
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Dates
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Enumeration Date | 08/02/2021
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Last Update Date | 08/02/2021
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Provider Practice Location Address
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Address Line | 1216 12TH ST
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City | HOOD RIVER
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State | OR
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Zip | 97031-1604
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Country | US
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Telephone | 541-386-3525
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Fax | 541-386-6647
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Provider Business Mailing Address
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Address Line | 2780 STATE ST STE 6
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City | SANTA BARBARA
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State | CA
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Zip | 93105-5522
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Country | US
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Telephone | 805-681-4848
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Fax | 805-456-0860
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MR. PATRICK TIMOTHY DILLON
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Credential |
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Telephone | 805-681-4848
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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