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General NPI Number Information
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NPI Number | 1699135590
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Entity Type | Individual
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Provider Name | AWAD KAMIL BDS,MSC,MFDRCSI
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Gender | Male
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Dates
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Enumeration Date | 03/04/2016
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 43130 AMBERWOOD PLZ STE 230
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City | SOUTH RIDING
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State | VA
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Zip | 20152-4110
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Country | US
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Telephone | 703-996-3520
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Fax |
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Provider Business Mailing Address
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Address Line | 4000 NW 51 ST APP B25 LACKE CROSSING
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City | GAINESVILLE
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State | FL
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Zip | 32606
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Country | US
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Telephone | 301-979-1809
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 0401415793
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License Number State | VA
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