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General NPI Number Information
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NPI Number | 1679971857
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Entity Type | Individual
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Provider Name | MHD AMER ALLAYMOUNI
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Gender | Male
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Dates
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Enumeration Date | 12/19/2014
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Last Update Date | 12/19/2014
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Provider Practice Location Address
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Address Line | 723 SOUTHPARK BLVD STE F
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City | COLONIAL HEIGHTS
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State | VA
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Zip | 23834-3628
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Country | US
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Telephone | 804-504-0012
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Fax |
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Provider Business Mailing Address
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Address Line | 2662 SHERIDAN DR APT 2
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City | TONAWANDA
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State | NY
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Zip | 14150-9449
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Country | US
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Telephone | 716-650-8439
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 0401414705
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License Number State | VA
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