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General NPI Number Information
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NPI Number | 1215143813
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Entity Type | Individual
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Provider Name | JARED CARTER KLEINE D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1333 NORTH SEMINOLE TRAIL
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City | MADISON
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State | VA
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Zip | 22727-0330
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Country | US
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Telephone | 540-948-4812
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Fax | 540-948-4831
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Provider Business Mailing Address
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Address Line | PO BOX 330 ROUTE 29 NORTH
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City | MADISON
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State | VA
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Zip | 22727-0330
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Country | US
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Telephone | 540-948-4812
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Fax | 540-948-4831
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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 | 0401008881
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License Number State | VA
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