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General NPI Number Information
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NPI Number | 1881745347
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Entity Type | Individual
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Provider Name | HAYTHAM MOHAMED ADEL ABBAS D.D.S
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Gender | Male
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 02/05/2019
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Provider Practice Location Address
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Address Line | 3880 TRUXEL RD STE 600
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City | SACRAMENTO
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State | CA
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Zip | 95834-3615
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Country | US
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Telephone | 916-333-2700
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Fax | 916-515-8209
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Provider Business Mailing Address
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Address Line | 9924 HAWKVIEW WAY
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City | ELK GROVE
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State | CA
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Zip | 95757-9323
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Country | US
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Telephone | 916-384-5579
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 53744
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License Number State | CA
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