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General NPI Number Information
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NPI Number | 1982395166
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Entity Type | Individual
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Provider Name | ANDREW MADISON HARRIS DMD
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Gender | Male
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Dates
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Enumeration Date | 05/17/2023
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Last Update Date | 05/17/2023
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Provider Practice Location Address
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Address Line | 1695 GOLDEN SPRINGS RD
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City | ANNISTON
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State | AL
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Zip | 36207-7097
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Country | US
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Telephone | 256-831-1333
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Fax |
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Provider Business Mailing Address
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Address Line | 6600 EMERALD FOREST DR
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City | MILTON
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State | FL
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Zip | 32570-8139
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Country | US
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Telephone | 850-313-0250
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | FL
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