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General NPI Number Information
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NPI Number | 1972643153
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Entity Type | Individual
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Provider Name | MICHAEL A MOWER DDS
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Gender | Male
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 12/13/2023
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Provider Practice Location Address
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Address Line | 7800 W USTICK RD STE 110
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City | BOISE
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State | ID
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Zip | 83704-5848
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Country | US
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Telephone | 208-322-0040
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Fax |
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Provider Business Mailing Address
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Address Line | 13619 N 59TH AVE
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City | GLENDALE
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State | AZ
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Zip | 85304-1203
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Country | US
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Telephone | 602-938-2911
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Fax | 602-938-5735
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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 | 5219
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License Number State | AZ
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