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General NPI Number Information
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NPI Number | 1639554108
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Entity Type | Organization
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Legal Business Name | BROWARD FAMILY DENTAL CARE, INC.
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Dates
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Enumeration Date | 07/27/2015
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Last Update Date | 07/27/2015
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Provider Practice Location Address
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Address Line | 6260 W OAKLAND PARK BLVD
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City | SUNRISE
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State | FL
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Zip | 33313-1214
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Country | US
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Telephone | 954-742-7995
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Fax | 954-742-2857
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Provider Business Mailing Address
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Address Line | 6260 W OAKLAND PARK BLVD
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City | SUNRISE
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State | FL
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Zip | 33313-1214
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Country | US
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Telephone | 954-742-7995
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Fax | 954-742-2857
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SAYED M FADAVI
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Credential | DDS
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Telephone | 954-742-7995
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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 | DN14848
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License Number State | FL
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