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General NPI Number Information
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NPI Number | 1790507457
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Entity Type | Organization
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Legal Business Name | WINFIELD DENTAL GROUP, LLC
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Dates
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Enumeration Date | 10/24/2024
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | 905 1/2 CREST RD
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City | DEL MAR
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State | CA
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Zip | 92014-2617
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Country | US
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Telephone | 858-213-4856
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Fax |
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Provider Business Mailing Address
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Address Line | 1155 CAMINO DEL MAR
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City | DEL MAR
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State | CA
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Zip | 92014-2605
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Country | US
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Telephone | 858-213-4856
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | JOHN WINFIELD
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Credential |
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Telephone | 858-213-4856
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number |
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License Number State |
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