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General NPI Number Information
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NPI Number | 1417061508
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Entity Type | Individual
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Provider Name | KEVIN DANIEL VERRRETT DDS
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Gender | Male
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 09/25/2008
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Provider Practice Location Address
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Address Line | 1708 EAST PASS ROAD
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City | GULFPORT
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State | MS
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Zip | 39507
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Country | US
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Telephone | 228-822-9190
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Fax | 228-822-9559
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Provider Business Mailing Address
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Address Line | 1708 EAST PASS ROAD
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City | GULFPORT
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State | MS
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Zip | 39507
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Country | US
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Telephone | 228-822-9190
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Fax | 228-822-9559
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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 | 2891-95
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License Number State | MS
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