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General NPI Number Information
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NPI Number | 1831246149
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Entity Type | Organization
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Legal Business Name | ALLIED DENTAL ASSOCIATES, INC.
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Dates
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Enumeration Date | 01/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1709 DRYDEN RD SUITE 1411
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City | HOUSTON
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State | TX
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Zip | 77030-2400
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Country | US
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Telephone | 713-520-7447
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Fax | 713-942-7070
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Provider Business Mailing Address
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Address Line | PO BOX 300547
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City | HOUSTON
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State | TX
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Zip | 77230-0547
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Country | US
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Telephone | 713-520-7447
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Fax | 713-942-7070
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Authorized Official
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Title or Position | OWNER
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Name | MR. BRIAN LEE KARASIC
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Credential | DMD
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Telephone | 713-520-7447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 13470
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License Number State | TX
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