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NPI 1689321119

NPI 1689321119 : TSUCHISTEIN DENTAL CARE INC : REDDING, CA

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General NPI Number Information
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    NPI Number           |    1689321119
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    Entity Type          |    Organization 
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    Legal Business Name  |    TSUCHISTEIN DENTAL CARE INC 
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Dates
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    Enumeration Date     |    03/04/2022
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    Last Update Date     |    03/11/2022
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Provider Practice Location Address
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    Address Line         |    2421 HARTNELL AVE STE A 
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    City                 |    REDDING
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    State                |    CA
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    Zip                  |    96002-2340
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    Country              |    US
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    Telephone            |    530-222-6939
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    Fax                  |    530-222-1797
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Provider Business Mailing Address
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    Address Line         |    7157 171ST AVE SE 
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    City                 |    BELLEVUE
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    State                |    WA
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    Zip                  |    98006-5724
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    Country              |    US
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    Telephone            |    206-852-6835
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    DR. TREVOR KENJI TSUCHIKAWA 
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    Credential           |    DDS
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    Telephone            |    206-852-6835
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QD0000X
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    Taxonomy Name        |    Dental Clinic/Center
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    License Number       |    
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    License Number State |    
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