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General NPI Number Information
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NPI Number | 1174190987
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Entity Type | Individual
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Provider Name | CODY LOWE DMD
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Gender | Female
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Dates
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Enumeration Date | 06/09/2021
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Last Update Date | 10/28/2021
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Provider Practice Location Address
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Address Line | 1912 W REYNOLDS ST
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City | PLANT CITY
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State | FL
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Zip | 33563-4700
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Country | US
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Telephone | 813-567-7001
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Fax |
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Provider Business Mailing Address
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Address Line | 607 SUNSET BEACH CT
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City | VALRICO
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State | FL
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Zip | 33594-7613
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Country | US
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Telephone | 239-331-1733
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DN25829
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License Number State | FL
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