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General NPI Number Information
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NPI Number | 1275701369
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Entity Type | Organization
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Legal Business Name | GEOFFREY A. KLOPENSTINE DDS PC
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Dates
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Enumeration Date | 02/12/2008
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Last Update Date | 02/12/2008
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Provider Practice Location Address
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Address Line | 51584 US HIGHWAY 33
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City | SOUTH BEND
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State | IN
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Zip | 46637-1704
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Country | US
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Telephone | 574-272-6575
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Fax |
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Provider Business Mailing Address
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Address Line | 51584 US HIGHWAY 33
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City | SOUTH BEND
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State | IN
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Zip | 46637-1704
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. GEOFFREY ALLEN KLOPENSTINE
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Credential | DDS
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Telephone | 574-272-6575
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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 | 12009913A
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License Number State | IN
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