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General NPI Number Information
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NPI Number | 1922268465
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Entity Type | Organization
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Legal Business Name | KEVIN S. BONE, D.D.S., PLC
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Dates
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Enumeration Date | 06/09/2008
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Last Update Date | 06/09/2008
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Provider Practice Location Address
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Address Line | 4170 STATE ST
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City | SAGINAW
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State | MI
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Zip | 48603-4025
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Country | US
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Telephone | 989-792-7461
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Fax | 989-792-8857
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Provider Business Mailing Address
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Address Line | 4170 STATE ST
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City | SAGINAW
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State | MI
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Zip | 48603-4025
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Country | US
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Telephone | 989-792-7461
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Fax | 989-792-8857
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KEVIN S. BONE
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Credential | D.D.S.
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Telephone | 989-799-8717
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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 | 146940
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License Number State | MI
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