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General NPI Number Information
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NPI Number | 1679069694
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Entity Type | Organization
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Legal Business Name | SHIOW JIIN JAW, DDS, INC.
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Dates
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Enumeration Date | 07/02/2018
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Last Update Date | 07/18/2018
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Provider Practice Location Address
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Address Line | 6270 ROSEMEAD BLVD
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City | TEMPLE CITY
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State | CA
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Zip | 91780
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Country | US
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Telephone | 626-622-8646
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Fax |
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Provider Business Mailing Address
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Address Line | 2848 CUMBERLAND RD
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City | SAN MARINO
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State | CA
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Zip | 91108-2204
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Country | US
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Telephone | 617-817-2037
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Fax | 626-766-1612
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SHIOW JIIN JAW
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Credential | DDS
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Telephone | 617-817-2037
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 38304
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License Number State | CA
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