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General NPI Number Information
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NPI Number | 1568009025
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Entity Type | Individual
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Provider Name | MICHAEL GOTT DMD
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Gender | Male
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Dates
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Enumeration Date | 12/04/2019
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Last Update Date | 12/04/2019
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Provider Practice Location Address
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Address Line | 6045 HAGEN RANCH RD STE 1
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City | LAKE WORTH
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State | FL
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Zip | 33467-7251
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Country | US
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Telephone | 954-958-0339
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Fax | 954-384-5474
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Provider Business Mailing Address
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Address Line | 6750 N ANDREWS AVE STE 200
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City | FORT LAUDERDALE
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State | FL
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Zip | 33309-2180
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Country | US
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Telephone | 954-873-7741
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Fax | 954-384-5474
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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 | 13997
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License Number State | FL
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