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NPI 1881922771

NPI 1881922771 : NOSTI PROFESSIONAL DENTAL CORPORATION : ESCONDIDO, CA

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General NPI Number Information
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    NPI Number           |    1881922771
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    Entity Type          |    Organization 
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    Legal Business Name  |    NOSTI PROFESSIONAL DENTAL CORPORATION 
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Dates
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    Enumeration Date     |    12/03/2009
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    Last Update Date     |    12/03/2009
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Provider Practice Location Address
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    Address Line         |    860 W VALLEY PKWY SUITE 100
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    City                 |    ESCONDIDO
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    State                |    CA
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    Zip                  |    92025-2534
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    Country              |    US
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    Telephone            |    760-745-1585
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2860 MICHELLE 2ND FLOOR
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    City                 |    IRVINE
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    State                |    CA
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    Zip                  |    92606-1009
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    Country              |    US
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    Telephone            |    714-368-2077
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    Fax                  |    714-368-2092
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Authorized Official
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    Title or Position    |    OWNER DOCTOR
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    Name                 |    DR. JOHN C NOSTI 
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    Credential           |    DDS
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    Telephone            |    760-745-1585
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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       |    
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    License Number State |    
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