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1568869501
EBBIE BOUTEHSAZ
BRONX, NY
NPI
1568869501
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: NY 058225-1)
Enumeration Date
2014-11-19
Last Update Date
2018-11-14
Business Address
EBBIE BOUTEHSAZ
3310 BAINBRIDGE AVE
BRONX, NY 10467
Phone number: 718-654-3456
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Mailing Address
EBBIE BOUTEHSAZ
3310 BAINBRIDGE AVE
BRONX, NY 10467-2856
Phone number: 718-654-3456
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