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General NPI Number Information
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NPI Number | 1689122541
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Entity Type | Organization
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Legal Business Name | DANIEL C SHIN, DDS, PC
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Dates
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Enumeration Date | 09/20/2016
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Last Update Date | 09/20/2016
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Provider Practice Location Address
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Address Line | 2835 SMITH AVE STE B
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City | BALTIMORE
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State | MD
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Zip | 21209-1454
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Country | US
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Telephone | 410-486-3636
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Fax | 410-486-3657
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Provider Business Mailing Address
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Address Line | 2835 SMITH AVE STE B
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City | BALTIMORE
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State | MD
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Zip | 21209-1454
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Country | US
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Telephone | 410-486-3636
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Fax | 410-486-3657
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DANIEL SHIN
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Credential | DDS
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Telephone | 410-486-3636
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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 | 15791
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License Number State | MD
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