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General NPI Number Information
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NPI Number | 1629286737
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Entity Type | Individual
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Provider Name | JASON ADAM STRAW D.D.S
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Gender | Male
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 4420 TOWN CENTER BLVD STE 250
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City | EL DORADO HILLS
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State | CA
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Zip | 95762-7138
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Country | US
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Telephone | 916-933-3332
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Fax | 916-358-8639
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Provider Business Mailing Address
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Address Line | 4420 TOWN CENTER BLVD STE 250
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City | EL DORADO HILLS
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State | CA
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Zip | 95762-7138
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Country | US
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Telephone | 916-933-3332
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Fax | 916-358-8639
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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 | 52782
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License Number State | CA
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