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General NPI Number Information
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NPI Number | 1821839853
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Entity Type | Individual
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Provider Name | MOHAMED ELHADI MOHAMED ALI DMD
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Gender | Male
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Dates
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Enumeration Date | 06/04/2024
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 9990 W 26TH AVE
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City | LAKEWOOD
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State | CO
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Zip | 80215-1581
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Country | US
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Telephone | 303-232-4500
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Fax |
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Provider Business Mailing Address
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Address Line | 500 WASHINGTON ST APT 506
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City | QUINCY
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State | MA
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Zip | 02169-5870
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Country | US
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Telephone | 929-248-9840
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DEN.00206018
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License Number State | CO
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