MEDICARE: DR. KARINA MARR D.D.S.

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	22237	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053416271
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KARINA MARR D.D.S.

Provider Business Mailing Address
First Line	:	6825 TOPSFIELD DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-5713
Country	:	US
Telephone Number	:	512-914-1486
Fax Number	:

Provider Business Practice Location Address
First Line	:	7005 PASTOR BAILEY DR STE 100A
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75237-2632
Country	:	US
Telephone Number	:	972-296-1835
Fax Number	:

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

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	07/26/2011

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