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General NPI Number Information
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NPI Number | 1609276146
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Entity Type | Individual
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Provider Name | ANDREW H. LAFONT DDS
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Gender | Male
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Dates
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Enumeration Date | 09/03/2014
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Last Update Date | 09/03/2014
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Provider Practice Location Address
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Address Line | 10601 SAN JOSE BLVD STE 117
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City | JACKSONVILLE
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State | FL
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Zip | 32257-6267
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Country | US
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Telephone | 904-483-3027
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Fax |
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Provider Business Mailing Address
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Address Line | 2592 COLLEGE ST
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City | JACKSONVILLE
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State | FL
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Zip | 32204-3504
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Country | US
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Telephone |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN 20935
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License Number State | FL
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