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General NPI Number Information
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NPI Number | 1407078009
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Entity Type | Organization
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Legal Business Name | ROBERT B. MCDADE, DMD, PSC
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1250 HWY 44E
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City | SHEPHERDSVILLE
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State | KY
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Zip | 40165
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Country | US
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Telephone | 502-543-2341
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Fax | 502-955-2006
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Provider Business Mailing Address
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Address Line | PO BOX 217
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City | SHEPHERDSVILLE
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State | KY
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Zip | 40165-0217
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Country | US
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Telephone | 502-955-6460
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Fax | 502-955-2006
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Authorized Official
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Title or Position | OWNER
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Name | ROBERT B. MCDADE
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Credential | DMD
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Telephone | 502-543-2341
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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 | 4981
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License Number State | KY
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