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General NPI Number Information
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NPI Number | 1487598645
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Entity Type | Individual
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Provider Name | LOWELL DOUGLAS SMITH
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Gender | Male
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Dates
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Enumeration Date | 04/17/2026
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Last Update Date | 04/17/2026
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Provider Practice Location Address
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Address Line | 1119 N 4TH ST
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City | COEUR D ALENE
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State | ID
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Zip | 83814-3216
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Country | US
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Telephone | 208-667-8997
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Fax |
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Provider Business Mailing Address
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Address Line | 10909 N DANIELLE RD
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City | HAYDEN
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State | ID
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Zip | 83835-8417
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Country | US
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Telephone | 208-930-9464
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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 | 122400000X
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Taxonomy Name | Denturist
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License Number |
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License Number State |
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