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General NPI Number Information
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NPI Number | 1720761943
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Entity Type | Organization
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Legal Business Name | RESTORATION EYE CARE PLLC
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Dates
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Enumeration Date | 08/14/2023
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Last Update Date | 04/10/2025
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Provider Practice Location Address
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Address Line | 2225 MAIN ST SW STE 140
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City | WYOMING
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State | MI
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Zip | 49519-9697
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Country | US
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Telephone | 616-287-5495
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Fax |
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Provider Business Mailing Address
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Address Line | 2225 MAIN ST SW STE 140
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City | WYOMING
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State | MI
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Zip | 49519-9697
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Country | US
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Telephone | 616-323-2002
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Fax | 616-699-5177
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Authorized Official
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Title or Position | OWNER/FOUNDER
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Name | TREVOR SMITH
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Credential | MD
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Telephone | 616-510-5858
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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