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NPI 1730392457

NPI 1730392457 : FRANK PAGANO DDS : WATERTOWN, NY

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General NPI Number Information
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    NPI Number           |    1730392457
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    Entity Type          |    Individual 
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    Provider Name        |    FRANK PAGANO DDS
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/08/2007
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    Last Update Date     |    12/09/2021
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Provider Practice Location Address
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    Address Line         |    238 ARSENAL ST 
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    City                 |    WATERTOWN
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    State                |    NY
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    Zip                  |    13601-2504
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    Country              |    US
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    Telephone            |    315-782-9450
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    Fax                  |    315-782-2643
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Provider Business Mailing Address
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    Address Line         |    238 ARSENAL ST 
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    City                 |    WATERTOWN
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    State                |    NY
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    Zip                  |    13601-2504
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    Country              |    US
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    Telephone            |    315-782-9450
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    Fax                  |    315-782-2643
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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        |    1223G0001X
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    Taxonomy Name        |    General Practice Dentistry
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    License Number       |    038745
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    License Number State |    NY
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