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General NPI Number Information
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NPI Number | 1871314112
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Entity Type | Individual
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Provider Name | GENESIS COLLADO VILLAFANE DMD
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Gender | Female
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Dates
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Enumeration Date | 10/19/2024
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Last Update Date | 05/11/2025
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Provider Practice Location Address
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Address Line | 10 CALLE ALMODOVAR
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City | JUNCOS
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State | PR
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Zip | 00777
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Country | US
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Telephone | 787-734-6546
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1741
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City | CAGUAS
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State | PR
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Zip | 00726-1741
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Country | US
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Telephone | 787-223-2297
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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 | 3519
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License Number State | PR
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