If you are using Responsive Web Design, use meta name="viewport" tag to tell the browser how to adjust the content. If you use Dynamic Serving, use the Vary HTTP header to signal your changes depending on the user-agent. If you are using separate URLs, signal the relationship between two URLs by tag with rel="canonical" and rel="alternate" elements.
QUOTE: “If you want to stop spam, the most straight forward way to do it is to deny people money because they care about the money and that should be their end goal. But if you really want to stop spam, it is a little bit mean, but what you want to do, is sort of break their spirits. There are lots of Google algorithms specifically designed to frustrate spammers. Some of the things we do is give people a hint their site will drop and then a week or two later, their site actually does drop. So they get a little bit more frustrated. So hopefully, and we’ve seen this happen, people step away from the dark side and say, you know what, that was so much pain and anguish and frustration, let’s just stay on the high road from now on.” Matt Cutts, Google 2013
QUOTE: “Returning a code other than 404 or 410 for a non-existent page (or redirecting users to another page, such as the homepage, instead of returning a 404) can be problematic. Firstly, it tells search engines that there’s a real page at that URL. As a result, that URL may be crawled and its content indexed. Because of the time Googlebot spends on non-existent pages, your unique URLs may not be discovered as quickly or visited as frequently and your site’s crawl coverage may be impacted (also, you probably don’t want your site to rank well for the search query” GOOGLE
QUOTE: “How do I move from one domain to another domain and try to preserve the rankings as best as possible?…do a 301 permanent redirect to the new location (assuming that you’re you’re moving for all time and eternity so this is the good case for a permanent or 301 redirect if you were planning to undo this later or it’s temporary then you’d use a 302 redirect)…. search engines should be able to follow the trail of all the 301 redirects” Matt Cutts, Google
QUOTE: “So there’s three things that you really want to do well if you want to be the world’s best search engine you want to crawl the web comprehensively and deeply you want to index those pages and then you want to rank or serve those pages and return the most relevant ones first….. we basically take PageRank as the primary determinant and the more PageRank you have that is the more people who link to you and the more reputable those people are the more likely it is we’re going to discover your page…. we use page rank as well as over 200 other factors in our rankings to try to say okay maybe this document is really authoritative it has a lot of reputation because it has a lot of PageRank … and that’s kind of the secret sauce trying to figure out a way to combine those 200 different ranking signals in order to find the most relevant document.” Matt Cutts, Google
A poor 404 page and user interaction with it, can only lead to a ‘poor user experience’ signal at Google’s end, for a number of reasons. I will highlight a poor 404 page in my audits and actually programmatically look for signs of this issue when I scan a site. I don’t know if Google looks at your site that way to rate it e.g. algorithmically determines if you have a good 404 page – or if it is a UX factor, something to be taken into consideration further down the line – or purely to get you thinking about 404 pages (in general) to help prevent Google wasting resources indexing crud pages and presenting poor results to searchers. I think rather that any rating would be a second order scoring including data from user activity on the SERPs – stuff we as SEO can’t see.
I think it makes sense to have unique content as much as possible on these pages but it’s not not going to like sync the whole website if you don’t do that we don’t penalize a website for having this kind of deep duplicate content and kind of going back to the first thing though with regards to doorway pages that is something I definitely look into to make sure that you’re not running into that so in particular if this is like all going to the same clinic and you’re creating all of these different landing pages that are essentially just funneling everyone to the same clinic then that could be seen as a doorway page or a set of doorway pages on our side and it could happen that the web spam team looks at that and says this is this is not okay you’re just trying to rank for all of these different variations of the keywords and the pages themselves are essentially all the same and they might go there and say we need to take a manual action and remove all these pages from search so that’s kind of one thing to watch out for in the sense that if they are all going to the same clinic then probably it makes sense to create some kind of a summary page instead whereas if these are going to two different businesses then of course that’s kind of a different situation it’s not it’s not a doorway page situation.” John Mueller, Google 2017
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Ask for a technical and search audit for your site to learn what they think needs to be done, why, and what the expected outcome should be. You'll probably have to pay for this. You will probably have to give them read-only access to your site on Search Console. (At this stage, don't grant them write access.) Your prospective SEO should be able to give you realistic estimates of improvement, and an estimate of the work involved. If they guarantee you that their changes will give you first place in search results, find someone else.