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General NPI Number Information
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NPI Number | 1588457097
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Entity Type | Individual
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Provider Name | KENDALL RAE WATSON DDS
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Gender | Female
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Dates
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Enumeration Date | 05/27/2025
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 4447 CAMINO REAL WAY
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City | FORT MYERS
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State | FL
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Zip | 33966-1019
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Country | US
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Telephone | 239-936-7400
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Fax |
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Provider Business Mailing Address
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Address Line | 4312 COASTERRA DR
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City | FORT MYERS
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State | FL
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Zip | 33916-8497
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Country | US
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Telephone | 239-689-9051
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DN30274
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License Number State | FL
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