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NPI 1992843437

NPI 1992843437 : PAUL MICHAEL CIUCI DMD, MD : MILFORD, CT

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General NPI Number Information
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    NPI Number           |    1992843437
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    Entity Type          |    Individual 
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    Provider Name        |    PAUL MICHAEL CIUCI DMD, MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    02/04/2007
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    Last Update Date     |    04/09/2010
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Provider Practice Location Address
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    Address Line         |    1 GOLDEN HILL ST 
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    City                 |    MILFORD
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    State                |    CT
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    Zip                  |    06460-4630
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    Country              |    US
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    Telephone            |    203-874-1664
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    Fax                  |    203-877-2027
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Provider Business Mailing Address
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    Address Line         |    1 GOLDEN HILL ST 
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    City                 |    MILFORD
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    State                |    CT
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    Zip                  |    06460-4630
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    Country              |    US
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    Telephone            |    203-874-1664
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    Fax                  |    203-877-2027
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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        |    1223S0112X
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    Taxonomy Name        |    Oral and Maxillofacial Surgery (Dentist)
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    License Number       |    009672
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    License Number State |    CT
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Taxonomy #2
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    Taxonomy Code        |    204E00000X
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    Taxonomy Name        |    Oral & Maxillofacial Surgery (D.M.D.)
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    License Number       |    45907
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    License Number State |    CT
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