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General NPI Number Information
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NPI Number | 1841100716
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Entity Type | Organization
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Legal Business Name | PARKSIDE PERIODONTAL AND IMPLANT CENTER LLC
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Dates
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Enumeration Date | 09/11/2026
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Last Update Date | 09/11/2026
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Provider Practice Location Address
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Address Line | 805 S MAPLE ST
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City | NORTH PLATTE
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State | NE
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Zip | 69101-5282
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Country | US
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Telephone | 308-534-1289
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Fax | 308-534-1530
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Provider Business Mailing Address
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Address Line | 805 S MAPLE ST
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City | NORTH PLATTE
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State | NE
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Zip | 69101-5282
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Country | US
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Telephone | 308-534-1289
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Fax | 308-534-1530
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Authorized Official
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Title or Position | OWNER
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Name | BENJAMIN LASHLEY
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Credential | DDS
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Telephone | 308-534-1289
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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