MEDICARE: MR. BENJAMIN DALE KARREN DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry	30658	TX

General Provider Information

NPI Number	:	1043403173
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BENJAMIN DALE KARREN DMD

Provider Business Mailing Address
First Line	:	2113 SW H K DODGEN LOOP
Second Line	:
City	:	TEMPLE
State	:	TX
Zip	:	76502-1849
Country	:	US
Telephone Number	:	254-433-7100
Fax Number	:	800-391-7468

Provider Business Practice Location Address
First Line	:	2113 SW H K DODGEN LOOP
Second Line	:
City	:	TEMPLE
State	:	TX
Zip	:	76502-1849
Country	:	US
Telephone Number	:	254-433-7100
Fax Number	:	800-391-7468

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2007
Last Update Date	:	04/16/2015

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