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General NPI Number Information
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NPI Number | 1083830095
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Entity Type | Individual
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Provider Name | KOSMAS KASIMATIS D.M.D
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Gender | Male
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 900 EASTON AVE STE 31
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City | SOMERSET
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State | NJ
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Zip | 08873-1760
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Country | US
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Telephone | 732-247-7417
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Fax | 732-828-7729
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Provider Business Mailing Address
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Address Line | 133 EMERSON RD
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City | SOMERSET
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State | NJ
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Zip | 08873-1616
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Country | US
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Telephone | 908-510-3080
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Fax | 732-828-7729
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DI20305
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License Number State | NJ
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