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General NPI Number Information
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NPI Number | 1710304944
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Entity Type | Organization
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Legal Business Name | STRAIGHT SMILES ORTHODONTICS PLLC
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Dates
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Enumeration Date | 03/26/2014
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Last Update Date | 03/26/2014
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Provider Practice Location Address
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Address Line | 259-19 HILLSIDE AVENUE
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City | FLORAL PARK
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State | NY
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Zip | 11004
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Country | US
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Telephone | 718-343-3411
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Fax | 718-343-3422
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Provider Business Mailing Address
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Address Line | 259-19 HILLSIDE AVENUE
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City | FLORAL PARK
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State | NY
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Zip | 11004
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Country | US
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Telephone | 718-343-3411
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Fax | 718-343-3422
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MOHIT H PATEL
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Credential | D.D.S
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Telephone | 917-861-1439
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 056558
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License Number State | NY
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