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General NPI Number Information
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NPI Number | 1992185052
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Entity Type | Organization
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Legal Business Name | DEAN E KOIS DMD MSD PLLC
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Dates
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Enumeration Date | 06/04/2015
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Last Update Date | 06/04/2015
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Provider Practice Location Address
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Address Line | 1119 4TH AVE
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City | SEATTLE
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State | WA
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Zip | 98101
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Country | US
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Telephone | 206-623-4400
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Fax | 206-623-4411
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Provider Business Mailing Address
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Address Line | 1001 FAIRVIEW AVE. N. SUITE 2200
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City | SEATTLE
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State | WA
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Zip | 98109
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Country | US
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Telephone | 206-515-9500
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Fax | 206-624-6030
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. TARA LAWSON KOIS
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Credential | DMD
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Telephone | 206-909-4597
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 10393
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License Number State | WA
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