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General NPI Number Information
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NPI Number | 1093867996
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Entity Type | Individual
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Provider Name | JON GOODWIN CARMAN D.D.S
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Gender | Male
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 07/29/2016
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Provider Practice Location Address
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Address Line | 1515 23RD ST
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City | GALVESTON
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State | TX
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Zip | 77550-4501
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Country | US
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Telephone | 409-765-6023
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Fax | 409-770-0313
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Provider Business Mailing Address
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Address Line | 6230 SANTO PARK RD
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City | DICKINSON
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State | TX
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Zip | 77539-8457
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Country | US
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Telephone | 409-457-1857
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 14288
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License Number State | TX
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