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General NPI Number Information
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NPI Number | 1578789632
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Entity Type | Individual
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Provider Name | DAVID C POELMAN DDS
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Gender | Male
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 03/13/2024
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Provider Practice Location Address
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Address Line | 1070 E RAY RD SUITE 7
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City | CHANDLER
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State | AZ
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Zip | 85225-1771
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Country | US
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Telephone | 480-792-6880
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Fax | 480-792-6870
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Provider Business Mailing Address
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Address Line | 185 S 163RD ST
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City | GILBERT
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State | AZ
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Zip | 85296-9475
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Country | US
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Telephone | 480-203-6415
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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 | AZ05638
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License Number State | AZ
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