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General NPI Number Information
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NPI Number | 1306575824
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Entity Type | Individual
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Provider Name | PRERAK GOEL DMD
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Gender | Male
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Dates
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Enumeration Date | 06/09/2022
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Last Update Date | 07/09/2023
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Provider Practice Location Address
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Address Line | 109 MIDDLESEX ST
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City | LOWELL
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State | MA
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Zip | 01852-2112
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Country | US
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Telephone | 978-441-1999
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Fax |
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Provider Business Mailing Address
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Address Line | 14 SARAH ST
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City | BURLINGTON
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State | MA
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Zip | 01803-1244
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Country | US
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Telephone | 508-353-5751
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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 | DN1859443
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License Number State | MA
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