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General NPI Number Information
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NPI Number | 1922912013
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Entity Type | Organization
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Legal Business Name | ADVANCED DENTISTRY IMPLANTS DENTURES INC
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Dates
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Enumeration Date | 09/28/2026
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Last Update Date | 09/28/2026
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Provider Practice Location Address
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Address Line | 1499 N SUSQUEHANNA TRL STE 2
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City | SELINSGROVE
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State | PA
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Zip | 17870-7783
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Country | US
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Telephone | 570-884-4000
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Fax | 570-844-8770
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Provider Business Mailing Address
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Address Line | 1499 N SUSQUEHANNA TRL STE 2
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City | SELINSGROVE
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State | PA
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Zip | 17870-7783
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Country | US
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Telephone | 570-884-4000
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF FINANCE
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Name | CAROLYN BATES
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Credential |
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Telephone | 716-622-1592
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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 | NULL
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State | NULL
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