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General NPI Number Information
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NPI Number | 1508032509
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Entity Type | Individual
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Provider Name | ROBERT L SIMMONS D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/30/2008
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Last Update Date | 04/30/2008
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Provider Practice Location Address
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Address Line | 2619 CAMPBELLSVILLE RD
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City | GREENSBURG
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State | KY
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Zip | 42743-9703
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Country | US
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Telephone | 270-932-4286
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Fax | 270-932-4267
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Provider Business Mailing Address
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Address Line | 2619 CAMPBELLSVILLE RD
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City | GREENSBURG
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State | KY
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Zip | 42743-9703
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Country | US
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Telephone | 270-932-4286
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Fax | 270-932-4267
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | KY7016
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License Number State | KY
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