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General NPI Number Information
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NPI Number | 1538950191
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Entity Type | Organization
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Legal Business Name | ABUNDANT DENTAL CARE LLC
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Dates
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Enumeration Date | 05/14/2025
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 332 S 500 E
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City | AMERICAN FORK
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State | UT
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Zip | 84003-2526
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Country | US
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Telephone | 385-644-5437
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Fax |
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Provider Business Mailing Address
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Address Line | 793 E WINCHESTER ST
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City | MURRAY
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State | UT
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Zip | 84107-7564
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Country | US
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Telephone | 801-849-1045
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Fax | 801-304-3151
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Authorized Official
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Title or Position | VP OF FINANCE
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Name | TRACIE SULLIVAN
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Credential |
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Telephone | 801-849-1045
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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 |
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License Number State |
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