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General NPI Number Information
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NPI Number | 1316812233
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Entity Type | Organization
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Legal Business Name | DENTIPASSLLC
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Dates
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Enumeration Date | 10/09/2025
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 498 JACKSON ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94111-1617
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Country | US
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Telephone | 657-248-8888
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Fax |
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Provider Business Mailing Address
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Address Line | 5830 E 2ND ST STE 7000
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City | CASPER
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State | WY
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Zip | 82609-4308
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Country | US
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Telephone | 657-248-8888
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | MOHAMMAD AMJAD KANDAR
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Credential | DO
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Telephone | 657-248-8888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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