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General NPI Number Information
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NPI Number | 1811260003
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Entity Type | Individual
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Provider Name | ANDREA B HOLSTEIN DMD
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Gender | Female
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Dates
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Enumeration Date | 02/17/2012
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Last Update Date | 02/17/2012
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Provider Practice Location Address
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Address Line | 10921 WILSHIRE BLVD SUITE 807
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City | LOS ANGELES
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State | CA
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Zip | 90024-3906
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Country | US
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Telephone | 310-209-5050
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Fax | 310-209-5550
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Provider Business Mailing Address
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Address Line | 3207 FRYMAN RD
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City | STUDIO CITY
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State | CA
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Zip | 91604-4115
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Country | US
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Telephone | 818-761-8851
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Fax | 818-761-8851
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 48611
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License Number State | CA
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