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General NPI Number Information
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NPI Number | 1619022449
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Entity Type | Individual
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Provider Name | JOLLY M CAPLASH DMD
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Gender | Male
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 08/22/2022
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Provider Practice Location Address
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Address Line | 10 HAGEN DR STE 230
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City | ROCHESTER
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State | NY
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Zip | 14625-2659
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Country | US
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Telephone | 585-442-1492
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Fax | 585-586-4460
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Provider Business Mailing Address
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Address Line | 10 HAGEN DR STE 230
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City | ROCHESTER
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State | NY
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Zip | 14625-2659
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Country | US
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Telephone | 585-442-1492
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 048025
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License Number State | NY
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