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General NPI Number Information
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NPI Number | 1679203012
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Entity Type | Organization
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Legal Business Name | RADIN DENTAL LLC
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Dates
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Enumeration Date | 06/16/2022
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Last Update Date | 06/16/2022
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Provider Practice Location Address
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Address Line | 6200 SAM CENTER RD SUITE B10
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City | SOLON
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State | OH
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Zip | 44139
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Country | US
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Telephone | 440-542-1200
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Fax |
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Provider Business Mailing Address
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Address Line | 13303 PRESCOTT LANE
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City | STRONGSVILLE
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State | OH
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Zip | 44136
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Country | US
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Telephone | 216-394-9657
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KYLE J RADIN
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Credential | DMD
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Telephone | 216-394-9657
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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 |
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License Number State |
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