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General NPI Number Information
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NPI Number | 1831746577
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Entity Type | Individual
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Provider Name | CHRIS SICINSKI DDS
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Gender | Male
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Dates
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Enumeration Date | 08/19/2019
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Last Update Date | 08/19/2019
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Provider Practice Location Address
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Address Line | 9000 CLINE AVE
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City | HIGHLAND
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State | IN
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Zip | 46322-2204
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Country | US
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Telephone | 219-923-2222
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Fax | 219-923-2222
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Provider Business Mailing Address
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Address Line | 1617 BLUEBIRD LN
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City | MUNSTER
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State | IN
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Zip | 46321-3322
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Country | US
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Telephone | 219-781-4358
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Fax | 219-923-2235
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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 | 12013226A
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License Number State | IN
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