Healthcare Provider Details

I. General information

NPI: 1235154188
Provider Name (Legal Business Name): KAREN LYNNE CABLE DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1199 COLONIAL RD
HARRISBURG PA
17112-1900
US

IV. Provider business mailing address

1199 COLONIAL RD
HARRISBURG PA
17112-1900
US

V. Phone/Fax

Practice location:
  • Phone: 717-652-8150
  • Fax: 717-652-8176
Mailing address:
  • Phone: 717-652-8150
  • Fax: 717-652-8176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License NumberDS028117L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: