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General NPI Number Information
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NPI Number | 1154594901
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Entity Type | Organization
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Legal Business Name | CUMBDENT, PSC
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Dates
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Enumeration Date | 04/11/2008
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Last Update Date | 04/22/2015
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Provider Practice Location Address
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Address Line | 54 IMAGING DRIVE
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City | SOMERSET
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State | KY
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Zip | 42503
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Country | US
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Telephone | 606-451-2273
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Fax | 606-451-9322
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Provider Business Mailing Address
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Address Line | 54 IMAGING DRIVE
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City | SOMERSET
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State | KY
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Zip | 42503
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Country | US
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Telephone | 606-451-2273
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Fax | 606-451-9322
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANNELEE JAYME
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Credential | DMD
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Telephone | 859-227-4605
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 7471
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 3301
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 7411
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License Number State | KY
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