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NPI 1740498591

NPI 1740498591 : YOLANDA BULAON DYCOCO-ESGUERRA DMD : COVINA, CA

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General NPI Number Information
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    NPI Number           |    1740498591
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    Entity Type          |    Individual 
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    Provider Name        |    YOLANDA BULAON DYCOCO-ESGUERRA DMD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/17/2007
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    Last Update Date     |    11/23/2010
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Provider Practice Location Address
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    Address Line         |    546 WEST BADILLO STREET SUITE E
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    City                 |    COVINA
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    State                |    CA
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    Zip                  |    91722
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    Country              |    US
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    Telephone            |    626-974-9382
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    Fax                  |    626-737-0665
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Provider Business Mailing Address
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    Address Line         |    546 WEST BADILLO STREET SUITE E
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    City                 |    COVINA
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    State                |    CA
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    Zip                  |    91722
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    Country              |    US
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    Telephone            |    626-974-9382
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    Fax                  |    626-737-0665
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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       |    43438
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    License Number State |    CA
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