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NPI 1740352624

NPI 1740352624 : RONALD JAY SALMONSON D.D.S. : SHOREHAM, NY

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General NPI Number Information
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    NPI Number           |    1740352624
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    Entity Type          |    Individual 
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    Provider Name        |    RONALD JAY SALMONSON D.D.S.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    11/15/2006
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    Last Update Date     |    03/17/2012
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Provider Practice Location Address
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    Address Line         |    47 N.COUNTRY RD. 
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    City                 |    SHOREHAM
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    State                |    NY
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    Zip                  |    11786
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    Country              |    US
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    Telephone            |    631-744-0111
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    Fax                  |    631-744-0321
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Provider Business Mailing Address
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    Address Line         |    PO BOX 849 
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    City                 |    SHOREHAM
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    State                |    NY
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    Zip                  |    11786-0849
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    Country              |    US
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    Telephone            |    631-744-0111
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    Fax                  |    631-744-0321
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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       |    029359
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    License Number State |    NY
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