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General NPI Number Information
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NPI Number | 1629280268
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Entity Type | Organization
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Legal Business Name | SUMMIT ENDODONTIC SPECIALISTS, INC
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3611 DARROW RD
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City | STOW
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State | OH
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Zip | 44224-4012
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Country | US
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Telephone | 330-686-0080
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Fax | 339-686-8622
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Provider Business Mailing Address
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Address Line | 3611 DARROW RD
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City | STOW
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State | OH
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Zip | 44224-4012
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Country | US
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Telephone | 330-686-0080
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Fax | 339-686-8622
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | WENDY M HARRIS
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Credential |
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Telephone | 330-686-0080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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