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General NPI Number Information
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NPI Number | 1255417911
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Entity Type | Individual
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Provider Name | KAMLESH MAHENDRA PATEL BDS
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Gender | Male
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Dates
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Enumeration Date | 10/27/2006
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Last Update Date | 09/03/2009
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Provider Practice Location Address
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Address Line | 1628 W BELMONT AVE
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City | CHICAGO
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State | IL
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Zip | 60657
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Country | US
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Telephone | 773-327-9500
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Fax | 773-327-3080
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Provider Business Mailing Address
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Address Line | 1628 W BELMONT AVE
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City | CHICAGO
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State | IL
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Zip | 60657
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Country | US
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Telephone | 773-327-9500
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Fax | 773-327-3080
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 021002036
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 019024966
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License Number State | IL
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