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General NPI Number Information
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NPI Number | 1558326397
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Entity Type | Individual
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Provider Name | JUDE ARTHUR FABIANO D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 04/17/2006
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Last Update Date | 05/14/2013
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Provider Practice Location Address
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Address Line | 175 PINEVIEW DR
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City | AMHERST
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State | NY
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Zip | 14228-2231
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Country | US
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Telephone | 716-869-1001
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Fax | 716-691-2283
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Provider Business Mailing Address
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Address Line | 366 MOUNT VERNON RD
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City | SNYDER
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State | NY
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Zip | 14226-4619
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Country | US
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Telephone | 716-839-5376
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 033289
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License Number State | NY
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