MEDICARE: KAREN M HALLINAN 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	9312	WA

General Provider Information

NPI Number	:	1700963451
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN M HALLINAN DDS

Provider Business Mailing Address
First Line	:	2806 S GRAND BLVD
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99203-2528
Country	:	US
Telephone Number	:	509-624-4311
Fax Number	:	509-624-1117

Provider Business Practice Location Address
First Line	:	2806 S GRAND BLVD
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99203-2528
Country	:	US
Telephone Number	:	509-624-4311
Fax Number	:	509-624-1117

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	07/08/2007

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