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General NPI Number Information
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NPI Number | 1265928865
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Entity Type | Organization
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Legal Business Name | FLAIR DENTAL PLLC
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Dates
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Enumeration Date | 07/06/2018
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Last Update Date | 07/09/2018
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Provider Practice Location Address
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Address Line | 3851 S STONEBRIDGE DR STE 100
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City | MCKINNEY
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State | TX
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Zip | 75070
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Country | US
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Telephone | 469-731-3332
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Fax |
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Provider Business Mailing Address
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Address Line | 125 AMBERWOOD DR
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City | COPPELL
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State | TX
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Zip | 75019-7969
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Country | US
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Telephone | 203-606-3155
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. LAKSHMI DEEPTHI YADDANAPUDI
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Credential | DMD
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Telephone | 469-731-3332
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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 | 25233
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License Number State | TX
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