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General NPI Number Information
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NPI Number | 1962501908
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Entity Type | Individual
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Provider Name | DANIEL JOSEPH KANE D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 21 PEACE ST DEPARTMENT OF PEDIATRIC DENTISTRY
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City | PROVIDENCE
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State | RI
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Zip | 02907-1510
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Country | US
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Telephone | 401-456-4463
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Fax | 401-456-4462
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Provider Business Mailing Address
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Address Line | 451 PLEASANT VALLEY PKWY
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City | PROVIDENCE
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State | RI
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Zip | 02908-3503
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Country | US
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Telephone | 401-351-1153
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DEN 02611
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License Number State | RI
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