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NPI 1790808525

NPI 1790808525 : RICHARD LOUIS BELLAGAMBA DDS : CONCORD, CA

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General NPI Number Information
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    NPI Number           |    1790808525
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    Entity Type          |    Individual 
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    Provider Name        |    RICHARD LOUIS BELLAGAMBA DDS
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    04/08/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    2939 SALVIO ST 
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    City                 |    CONCORD
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    State                |    CA
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    Zip                  |    94519-2534
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    Country              |    US
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    Telephone            |    925-680-7881
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2939 SALVIO ST 
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    City                 |    CONCORD
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    State                |    CA
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    Zip                  |    94519-2534
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    Country              |    US
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    Telephone            |    925-680-7881
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    Fax                  |    
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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        |    1223P0700X
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    Taxonomy Name        |    Prosthodontics
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    License Number       |    27729
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    License Number State |    CA
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