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General NPI Number Information
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NPI Number | 1609936061
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Entity Type | Individual
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Provider Name | KEVIN PETER LAHR DDS
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Gender | Male
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Dates
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Enumeration Date | 12/08/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5320 HYLAND GREENS DR SUITE 200
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City | BLOOMINGTON
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State | MN
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Zip | 55437-3934
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Country | US
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Telephone | 952-831-6126
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Fax | 952-831-3225
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Provider Business Mailing Address
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Address Line | 2384 APACHE CT
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City | MENDOTA HEIGHTS
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State | MN
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Zip | 55120-1684
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Country | US
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Telephone | 651-688-0857
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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 | D10040
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License Number State | MN
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