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General NPI Number Information
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NPI Number | 1932182755
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Entity Type | Individual
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Provider Name | SILVESTRO IOMMAZZO JR. D.D.S
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Gender | Male
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Dates
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Enumeration Date | 11/25/2005
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Last Update Date | 05/09/2016
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Provider Practice Location Address
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Address Line | 176 -60 UNION TURNPIKE SUITE 120
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City | FLUSHING
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State | NY
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Zip | 11366
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Country | US
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Telephone | 718-969-1700
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Fax | 718-969-1058
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Provider Business Mailing Address
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Address Line | 127 KINGS HWY N
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City | WESTPORT
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State | CT
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Zip | 06880-2422
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Country | US
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Telephone | 203-227-2377
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Fax | 203-227-1682
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 044312
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License Number State | NY
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