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General NPI Number Information
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NPI Number | 1780718411
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Entity Type | Individual
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Provider Name | DAMONE E SMITH DDS
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Gender | Male
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 12/26/2018
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Provider Practice Location Address
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Address Line | 12651 W SUNRISE BLVD #304
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City | SUNRISE
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State | FL
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Zip | 33323-0906
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Country | US
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Telephone | 954-845-0098
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Fax | 954-845-0280
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Provider Business Mailing Address
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Address Line | 12651 W SUNRISE BLVD #304
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City | SUNRISE
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State | FL
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Zip | 33323-0906
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Country | US
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Telephone | 954-845-0098
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Fax | 954-845-0280
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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 | 1223P0106X
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Taxonomy Name | Oral and Maxillofacial Pathology Dentistry
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License Number | DN16448
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DN16448
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License Number State | FL
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