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General NPI Number Information
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NPI Number | 1942683198
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Entity Type | Organization
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Legal Business Name | MALONE DENTAL PLAZA, PC
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Dates
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Enumeration Date | 07/07/2015
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Last Update Date | 07/07/2015
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Provider Practice Location Address
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Address Line | 209 W MAIN ST SUITE 2
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City | MALONE
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State | NY
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Zip | 12953-6400
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Country | US
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Telephone | 518-521-3843
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Fax | 518-319-4242
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Provider Business Mailing Address
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Address Line | 209 W MAIN ST SUITE 2
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City | MALONE
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State | NY
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Zip | 12953-6400
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Country | US
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Telephone | 518-521-3843
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Fax | 518-319-4242
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | MORRIS E FEINBERG
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Credential | DMD
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Telephone | 518-521-3843
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223D0004X
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Taxonomy Name | Dental Anesthesiology
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License Number | 000649
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License Number State | NY
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