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General NPI Number Information
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NPI Number | 1700082096
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Entity Type | Individual
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Provider Name | TODD L. VACCARO DDS
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Gender | Male
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Dates
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Enumeration Date | 06/22/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1771 UNION ST
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City | NISKAYUNA
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State | NY
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Zip | 12309-6311
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Country | US
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Telephone | 518-377-3628
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Fax |
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Provider Business Mailing Address
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Address Line | 8 WYNGATE DR
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City | GLENMONT
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State | NY
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Zip | 12077-3132
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Country | US
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Telephone | 518-225-6815
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 049145
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License Number State | NY
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