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NPI 1528020567

NPI 1528020567 : MICHAEL J MINARCHEK DR : BETHEL, OH

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General NPI Number Information
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    NPI Number           |    1528020567
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    Entity Type          |    Individual 
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    Provider Name        |    MICHAEL J MINARCHEK DR
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    04/05/2006
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    Last Update Date     |    03/17/2008
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Provider Practice Location Address
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    Address Line         |    420 WEST PLANE ST 
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    City                 |    BETHEL
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    State                |    OH
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    Zip                  |    45106
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    Country              |    US
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    Telephone            |    513-734-0120
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    Fax                  |    513-734-2029
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Provider Business Mailing Address
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    Address Line         |    420 WEST PLANE ST 
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    City                 |    BETHEL
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    State                |    OH
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    Zip                  |    45106
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    Country              |    US
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    Telephone            |    513-734-0120
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    Fax                  |    513-734-2029
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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       |    30016322
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    License Number State |    OH
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