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1124180054
SAMUEL PONCE NANDIN
GOODYEAR, AZ
NPI
1124180054
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
208D00000X General Practice
(Licence: AZ az15582)
Enumeration Date
2006-12-15
Last Update Date
2018-06-21
Business Address
Dr. SAMUEL PONCE NANDIN M.D.
13851 W LA MAR BLVD STE C
GOODYEAR, AZ 85338-1389
Phone number: 623-925-2622
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Mailing Address
Dr. SAMUEL PONCE NANDIN M.D.
13851 W LA MAR BLVD STE C
GOODYEAR, AZ 85338-1389
Phone number: 623-925-2622
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