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General NPI Number Information
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NPI Number | 1538179957
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Entity Type | Organization
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Legal Business Name | RENE DEL ROSARIO DMD
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 34743 ARDENWOOD BLVD
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City | FREMONT
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State | CA
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Zip | 94555-3654
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Country | US
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Telephone | 510-494-0404
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Fax | 510-494-1621
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Provider Business Mailing Address
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Address Line | 34743 ARDENWOOD BLVD
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City | FREMONT
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State | CA
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Zip | 94555-3654
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Country | US
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Telephone | 510-494-0404
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Fax | 510-494-1621
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Authorized Official
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Title or Position | BUSINESS ADMINISTRATOR
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Name | MRS. AGNES L CASTANEDA
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Credential |
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Telephone | 510-494-0404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 38667
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License Number State | CA
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