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General NPI Number Information
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NPI Number | 1942502620
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Entity Type | Organization
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Legal Business Name | ATRIUM DENTAL GROUP, INC.
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Dates
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Enumeration Date | 12/01/2010
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Last Update Date | 12/01/2010
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Provider Practice Location Address
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Address Line | 100 SHAKER RD
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City | EAST LONGMEADOW
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State | MA
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Zip | 01028-2731
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Country | US
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Telephone | 413-525-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 100 SHAKER RD
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City | EAST LONGMEADOW
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State | MA
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Zip | 01028
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Country | US
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Telephone | 413-525-3000
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Fax |
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | TOMASZ A CHRZAN
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Credential |
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Telephone | 413-525-3000
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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 | 21508
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License Number State | MA
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