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General NPI Number Information
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NPI Number | 1982897088
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Entity Type | Organization
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Legal Business Name | CINCINNATIORAL&MAXILLOFACIAL SURGERY ASSOC.,INC.
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Dates
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Enumeration Date | 08/22/2007
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Last Update Date | 08/22/2007
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Provider Practice Location Address
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Address Line | 7611 CHEVIOT RD
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City | CINCINNATI
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State | OH
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Zip | 45247-4036
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Country | US
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Telephone | 513-385-8600
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Fax |
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Provider Business Mailing Address
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Address Line | 7140 MIAMI AVE
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City | CINCINNATI
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State | OH
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Zip | 45243-2676
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | STEVEN P PIEPER
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Credential | DDS
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Telephone | 513-385-8600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 30019564
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License Number State | OH
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