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General NPI Number Information
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NPI Number | 1356974653
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Entity Type | Individual
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Provider Name | COLEEN M SMEAD RDH
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Gender | Female
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Dates
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Enumeration Date | 02/15/2020
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Last Update Date | 02/15/2020
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Provider Practice Location Address
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Address Line | 801 CENTRAL AVE
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City | DOVER
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State | NH
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Zip | 03820-2529
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Country | US
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Telephone | 603-742-8844
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Fax |
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Provider Business Mailing Address
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Address Line | 31 LIL NOR AVE
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City | SOMERSWORTH
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State | NH
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Zip | 03878-1907
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Country | US
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Telephone | 603-502-6546
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number |
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License Number State |
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