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General NPI Number Information
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NPI Number | 1699674721
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Entity Type | Organization
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Legal Business Name | TRU DENTAL LLC
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Dates
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Enumeration Date | 11/04/2026
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Last Update Date | 11/04/2026
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Provider Practice Location Address
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Address Line | 1650 NE 124TH ST SUITE 200
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City | NORTH MIAMI
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State | FL
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Zip | 33181
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Country | US
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Telephone | 305-813-0600
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Fax | 305-306-6297
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Provider Business Mailing Address
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Address Line | 1650 NE 124TH ST SUITE 200
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City | NORTH MIAMI
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State | FL
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Zip | 33181
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Country | US
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Telephone | 305-813-0600
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Fax | 305-306-6297
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Authorized Official
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Title or Position | MANAGER
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Name | RAUL TRUJILLO
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Credential | DMD
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Telephone | 561-541-9294
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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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