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General NPI Number Information
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NPI Number | 1437376068
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Entity Type | Individual
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Provider Name | ANDON DAN ALLEN LD
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Gender | Male
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6226 196TH ST SW 2B
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City | LYNNWOOD
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State | WA
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Zip | 98036-5959
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Country | US
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Telephone | 425-670-8670
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Fax | 425-670-0491
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Provider Business Mailing Address
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Address Line | 5527 6TH AVE NW
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City | TULALIP
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State | WA
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Zip | 98271-6531
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Country | US
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Telephone | 360-657-3315
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Fax | 425-670-0491
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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 | 122400000X
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Taxonomy Name | Denturist
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License Number | 00000017
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License Number State | WA
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