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General NPI Number Information
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NPI Number | 1841645231
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Entity Type | Individual
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Provider Name | KENNETH MCKENZIE CLOW D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/04/2016
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 8995 SW MILEY RD STE 101
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City | WILSONVILLE
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State | OR
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Zip | 97070-5485
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Country | US
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Telephone | 971-433-2724
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Fax |
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Provider Business Mailing Address
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Address Line | 28651 GREENWAY DR
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City | WILSONVILLE
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State | OR
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Zip | 97070-7752
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Country | US
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Telephone | 503-880-3733
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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 | 135501
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License Number State | AK
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D10652
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 25369
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License Number State | MT
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