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General NPI Number Information
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NPI Number | 1215183058
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Entity Type | Individual
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Provider Name | KATHERINE ANNE CARROLL DMD
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Gender | Female
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Dates
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Enumeration Date | 08/12/2008
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Last Update Date | 06/05/2024
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Provider Practice Location Address
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Address Line | 337 MAIN ST STE A
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City | GROVEPORT
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State | OH
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Zip | 43125-1127
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Country | US
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Telephone | 614-836-2222
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Fax | 614-343-2212
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Provider Business Mailing Address
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Address Line | 137 S COLUMBIA AVE
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City | BEXLEY
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State | OH
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Zip | 43209-1622
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Country | US
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Telephone | 614-836-2222
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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 | 30.022948
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License Number State | OH
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