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General NPI Number Information
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NPI Number | 1528370731
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Entity Type | Individual
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Provider Name | LUIS A ALCALDE-PRESEDO D.D.S, M.D.S
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Gender | Male
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Dates
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Enumeration Date | 07/06/2010
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 820 N STATE ROAD 434 STE B
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-7036
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Country | US
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Telephone | 407-278-1210
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Fax |
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Provider Business Mailing Address
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Address Line | 820 STATE RD, 434 N., SUITE B
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714
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Country | US
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Telephone | 407-278-1210
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | DN22522
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License Number State | FL
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