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NPI 1528267242

NPI 1528267242 : LINDSEY KECK DDS : ROCHESTER, NY

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General NPI Number Information
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    NPI Number           |    1528267242
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    Entity Type          |    Individual 
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    Provider Name        |    LINDSEY KECK DDS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/12/2007
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    Last Update Date     |    10/05/2009
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Provider Practice Location Address
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    Address Line         |    261 AVERILL AVE 
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    City                 |    ROCHESTER
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    State                |    NY
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    Zip                  |    14620-1301
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    Country              |    US
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    Telephone            |    585-314-3768
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    261 AVERILL AVE 
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    City                 |    ROCHESTER
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    State                |    NY
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    Zip                  |    14620-1301
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    Country              |    US
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    Telephone            |    585-314-3768
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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        |    1223P0221X
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    Taxonomy Name        |    Pediatric Dentistry
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    License Number       |    054537
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    License Number State |    NY
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