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General NPI Number Information
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NPI Number | 1124240460
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Entity Type | Individual
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Provider Name | KEITH KY KHUU DDS
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Gender | Male
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 11/23/2009
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Provider Practice Location Address
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Address Line | 889 CASTRO ST
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94041-2014
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Country | US
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Telephone | 650-969-5488
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Fax | 650-969-7546
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Provider Business Mailing Address
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Address Line | 120 CONIFER LANE
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City | WALNUT CREEK
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State | CA
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Zip | 94598
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Country | US
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Telephone | 714-675-0915
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Fax | 650-969-7546
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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 | 45718
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License Number State | CA
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