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General NPI Number Information
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NPI Number | 1295041689
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Entity Type | Individual
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Provider Name | MICHAEL ANTHONY BOHMAN DMD
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Gender | Male
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Dates
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Enumeration Date | 08/24/2010
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Last Update Date | 02/09/2024
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Provider Practice Location Address
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Address Line | 695 KINKAID RD
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City | ANNAPOLIS
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State | MD
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Zip | 21402-1006
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Country | US
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Telephone | 410-293-3901
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Fax |
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Provider Business Mailing Address
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Address Line | 7700 ARLINGTON BLVD # 2NW218C
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City | FALLS CHURCH
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State | VA
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Zip | 22042-2929
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Country | US
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Telephone | 703-681-9070
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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 | 7777249-9926
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License Number State | UT
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