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General NPI Number Information
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NPI Number | 1710081906
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Entity Type | Individual
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Provider Name | MICHAEL LUIS FUENTES D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 09/11/2006
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Last Update Date | 03/31/2026
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Provider Practice Location Address
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Address Line | 12065 SPRING CYPRESS RD.
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City | TOMBALL
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State | TX
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Zip | 77377
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Country | US
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Telephone | 281-205-7211
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Fax | 832-843-6150
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Provider Business Mailing Address
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Address Line | 12065 SPRING CYPRESS RD.
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City | TOMBALL
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State | TX
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Zip | 77377
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Country | US
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Telephone | 281-205-7211
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Fax | 832-843-6150
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 22605
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License Number State | TX
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