MEDICARE: KAREN S. ROMINE 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	6171	NC

General Provider Information

NPI Number	:	1164459517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN S. ROMINE DDS

Provider Business Mailing Address
First Line	:	1233 CARTHAGE ST
Second Line	:
City	:	SANFORD
State	:	NC
Zip	:	27330-8984
Country	:	US
Telephone Number	:	919-775-5200
Fax Number	:	191-977-6336

Provider Business Practice Location Address
First Line	:	1233 CARTHAGE ST
Second Line	:
City	:	SANFORD
State	:	NC
Zip	:	27330-8984
Country	:	US
Telephone Number	:	191-977-5520
Fax Number	:	191-977-6633

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

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	07/08/2007

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