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General NPI Number Information
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NPI Number | 1851102032
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Entity Type | Individual
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Provider Name | WILLIAM UDALL
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Gender | Male
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Dates
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Enumeration Date | 01/16/2025
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Last Update Date | 01/20/2025
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Provider Practice Location Address
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Address Line | E, 2900 SEMINARY DR
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City | GREENSBURG
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State | PA
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Zip | 15601
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Country | US
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Telephone | 724-552-2950
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Fax |
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Provider Business Mailing Address
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Address Line | 566 REED CT
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City | JEANNETTE
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State | PA
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Zip | 15644-4080
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Country | US
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Telephone |
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DS044430
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License Number State | PA
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