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General NPI Number Information
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NPI Number | 1033355581
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Entity Type | Organization
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Legal Business Name | BELLEVUE NEUROMUSCULAR DENTISTRY LLC
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Dates
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Enumeration Date | 01/05/2009
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Last Update Date | 01/05/2009
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Provider Practice Location Address
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Address Line | 1515 116TH AVE NE SUITE 303
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City | BELLEVUE
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State | WA
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Zip | 98004-3811
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Country | US
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Telephone | 425-637-1000
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Fax | 206-682-0775
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Provider Business Mailing Address
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Address Line | 1515 116TH AVE NE SUITE 303
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City | BELLEVUE
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State | WA
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Zip | 98004-3811
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Country | US
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Telephone | 425-637-1000
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Fax | 206-682-0775
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Authorized Official
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Title or Position | OWNER
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Name | DR. WILLAM CRIS SIMMONS
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Credential | DDS
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Telephone | 425-637-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 6392
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License Number State | WA
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