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General NPI Number Information
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NPI Number | 1932517356
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Entity Type | Organization
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Legal Business Name | JUSTIN SCHMIDT DDS PC
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Dates
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Enumeration Date | 07/29/2014
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Last Update Date | 07/29/2014
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Provider Practice Location Address
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Address Line | 1825 BELMONT AVE
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City | HOOD RIVER
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State | OR
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Zip | 97031-1657
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Country | US
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Telephone | 541-386-3818
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Fax |
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Provider Business Mailing Address
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Address Line | 1825 BELMONT AVE
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City | HOOD RIVER
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State | OR
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Zip | 97031-1657
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Country | US
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Telephone | 541-386-3818
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JUSTIN SCHMIDT
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Credential | DDS
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Telephone | 541-386-3818
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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 | D9659
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License Number State | OR
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