MEDICARE: MR. RICHARD A. KREN DDS

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	122300000X	Dentist	30016514	OH

General Provider Information

NPI Number	:	1205087194
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RICHARD A. KREN DDS

Provider Business Mailing Address
First Line	:	7057 WEST 130TH STREET
Second Line	:
City	:	PARMA HTS.
State	:	OH
Zip	:	44130
Country	:	US
Telephone Number	:	440-887-1121
Fax Number	:	440-887-9696

Provider Business Practice Location Address
First Line	:	7057 WEST 130TH STREET
Second Line	:	SUITE 302
City	:	PARMA HTS.
State	:	OH
Zip	:	44130
Country	:	US
Telephone Number	:	440-887-1121
Fax Number	:	440-887-9696

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

Provider Enumeration Date	:	10/09/2008
Last Update Date	:	10/09/2008

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