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General NPI Number Information
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NPI Number | 1750423695
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Entity Type | Individual
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Provider Name | DR. MARCELLE E. KOBROSSI
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Gender | Female
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 260 W. FOOTHILL BLVD.
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City | RIALTO
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State | CA
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Zip | 92376-5048
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Country | US
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Telephone | 909-546-1366
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Fax | 909-820-7561
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Provider Business Mailing Address
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Address Line | 551 W GREENWOOD AVE APT. #03
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City | LA HABRA
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State | CA
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Zip | 90631-3757
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Country | US
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Telephone | 909-546-1366
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Fax | 714-571-3560
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 55200
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License Number State | CA
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