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General NPI Number Information
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NPI Number | 1255657722
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Entity Type | Organization
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Legal Business Name | BESTCARE DENTAL LLC
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Dates
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Enumeration Date | 04/08/2010
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Last Update Date | 04/08/2010
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Provider Practice Location Address
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Address Line | 390 W 920 N
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City | OREM
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State | UT
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Zip | 84057-3042
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Country | US
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Telephone | 801-225-0471
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Fax | 801-225-4461
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Provider Business Mailing Address
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Address Line | 390 W 920 N
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City | OREM
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State | UT
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Zip | 84057-3042
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Country | US
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Telephone | 801-225-0471
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Fax | 801-225-4461
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Authorized Official
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Title or Position | MEMBER/MANAGER
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Name | DR. KYLE E FARLEY
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Credential | DDS
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Telephone | 801-225-0471
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 56798149922
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License Number State | UT
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