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General NPI Number Information
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NPI Number | 1710194428
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Entity Type | Organization
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Legal Business Name | MARIFLOR DUHAY DMD INC
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 07/28/2008
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Provider Practice Location Address
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Address Line | 340 4TH AVE SUITE 15
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City | CHULA VISTA
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State | CA
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Zip | 91910-3813
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Country | US
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Telephone | 619-422-6121
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Fax | 619-422-8082
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Provider Business Mailing Address
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Address Line | 340 4TH AVE SUITE 15
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City | CHULA VISTA
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State | CA
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Zip | 91910-3813
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Country | US
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Telephone | 619-422-6121
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Fax | 619-422-8082
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARIFLOR DUHAYLUNGSOD
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Credential | DMD
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Telephone | 619-422-6121
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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 | 50458
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License Number State | CA
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