MEDICARE: DR. KARLTON SCOTT HEDIN 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	1223G0001X	General Practice Dentistry	9960	MN

General Provider Information

NPI Number	:	1427061019
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KARLTON SCOTT HEDIN DDS

Provider Business Mailing Address
First Line	:	11707 WILD HERON POINT
Second Line	:
City	:	EDEN PAIRIE
State	:	MN
Zip	:	55437
Country	:	US
Telephone Number	:	952-942-5221
Fax Number	:

Provider Business Practice Location Address
First Line	:	16372 KENRICK AVE
Second Line	:	SUITE 200
City	:	LAKEVILLE
State	:	MN
Zip	:	55044-3540
Country	:	US
Telephone Number	:	952-435-5905
Fax Number	:	952-435-6291

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

Provider Enumeration Date	:	08/14/2006
Last Update Date	:	07/08/2007

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