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General NPI Number Information
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NPI Number | 1205279833
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Entity Type | Individual
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Provider Name | AMY HEIM D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 04/13/2013
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Last Update Date | 09/19/2014
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Provider Practice Location Address
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Address Line | 620 WASHINGTON ST
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City | PORTSMOUTH
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State | OH
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Zip | 45662-3920
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Country | US
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Telephone | 740-354-5763
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Fax |
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Provider Business Mailing Address
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Address Line | 1235 DISTEL LN
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City | PORTSMOUTH
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State | OH
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Zip | 45662-6411
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Country | US
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Telephone | 614-725-8801
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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 | 30.024246
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | OH
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