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General NPI Number Information
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NPI Number | 1902823651
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Entity Type | Individual
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Provider Name | ANDREW JAY SLODOV DDS, MSD
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Gender | Male
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 06/21/2024
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Provider Practice Location Address
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Address Line | 29001 CEDAR RD STE 675
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City | LYNDHURST
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State | OH
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Zip | 44124-4041
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Country | US
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Telephone | 330-998-2662
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Fax | 330-963-9926
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Provider Business Mailing Address
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Address Line | 29001 CEDAR RD STE 675
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City | LYNDHURST
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State | OH
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Zip | 44124-4041
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Country | US
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Telephone | 404-357-9294
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Fax | 330-963-9926
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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 | 30018655
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License Number State | OH
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