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General NPI Number Information
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NPI Number | 1013751262
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Entity Type | Individual
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Provider Name | KAMARIA RASHIDA BURKE
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Gender | Female
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Dates
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Enumeration Date | 06/22/2024
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Last Update Date | 06/22/2024
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Provider Practice Location Address
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Address Line | 42450 W 12 MILE RD STE 200
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City | NOVI
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State | MI
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Zip | 48377-3011
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Country | US
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Telephone | 248-348-8808
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Fax |
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Provider Business Mailing Address
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Address Line | 6600 INKSTER RD
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48322-4303
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Country | US
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Telephone | 313-662-8357
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Fax |
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 2902018407
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License Number State | MI
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