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General NPI Number Information
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NPI Number | 1669147997
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Entity Type | Individual
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Provider Name | DEVKI J PATEL DMD
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Gender | Female
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Dates
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Enumeration Date | 08/10/2021
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Last Update Date | 08/10/2021
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Provider Practice Location Address
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Address Line | 2000 RIVERSIDE PKWY STE 200
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-5926
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Country | US
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Telephone | 813-992-0919
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Fax |
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Provider Business Mailing Address
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Address Line | 3465 DULUTH HIGHWAY 120 APT 3503
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City | DULUTH
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State | GA
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Zip | 30096-3436
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Country | US
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Telephone | 813-992-0919
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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 | DN122448
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License Number State | GA
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