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General NPI Number Information
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NPI Number | 1649562893
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Entity Type | Individual
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Provider Name | RICHARD SALAS D.D.S., M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/06/2011
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Last Update Date | 09/20/2018
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Provider Practice Location Address
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Address Line | 666 LEXINGTON AVE STE 203
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City | MOUNT KISCO
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State | NY
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Zip | 10549-3637
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Country | US
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Telephone | 212-746-5190
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Fax |
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Provider Business Mailing Address
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Address Line | 666 LEXINGTON AVE STE 203
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City | MOUNT KISCO
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State | NY
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Zip | 10549-3637
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Country | US
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Telephone | 914-486-5600
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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 | 059118
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License Number State | NY
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