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General NPI Number Information
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NPI Number | 1043229545
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Entity Type | Individual
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Provider Name | ALAN R GOULD DDS, MS
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Gender | Male
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 02/22/2021
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Provider Practice Location Address
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Address Line | 5805 W HIGHWAY 22
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City | CRESTWOOD
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State | KY
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Zip | 40014-7244
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Country | US
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Telephone | 502-241-7116
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Fax | 502-241-2339
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Provider Business Mailing Address
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Address Line | 1941 BISHOP LN STE 1018
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City | LOUISVILLE
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State | KY
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Zip | 40218-1928
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Country | US
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Telephone | 502-456-6217
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Fax | 502-456-4440
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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 | 1223P0106X
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Taxonomy Name | Oral and Maxillofacial Pathology Dentistry
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License Number | 12010715A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 1223P0106X
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Taxonomy Name | Oral and Maxillofacial Pathology Dentistry
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License Number | 4925
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License Number State | KY
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