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General NPI Number Information
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NPI Number | 1669698593
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Entity Type | Individual
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Provider Name | JANIS P. PRESTON D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 11/07/2016
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Provider Practice Location Address
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Address Line | 2154 FAIRPORT NINE MILE PT RD
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City | FAIRPORT
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State | NY
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Zip | 14450-8743
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Country | US
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Telephone | 585-880-5520
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Fax |
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Provider Business Mailing Address
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Address Line | 2154 FAIRPORT NINE MILE PT RD
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City | FAIRPORT
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State | NY
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Zip | 14450-8743
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Country | US
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Telephone | 585-880-5520
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 0523801
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License Number State | NY
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