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General NPI Number Information
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NPI Number | 1639390107
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Entity Type | Individual
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Provider Name | MARVIN DANILO PEREZ DDS
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Gender | Male
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 17185 ARROW BLVD
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City | FONTANA
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State | CA
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Zip | 92335-3972
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Country | US
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Telephone | 909-822-4777
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Fax | 909-822-2926
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Provider Business Mailing Address
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Address Line | 5546 NEWBRIAR WAY
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City | CHINO HILLS
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State | CA
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Zip | 91709-8799
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Country | US
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Telephone | 310-908-8242
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 53096
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License Number State | CA
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