MEDICARE: DR. AMARDEEP TONY KHARA D.M.D.

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	8096	NC

General Provider Information

NPI Number	:	1184650335
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMARDEEP TONY KHARA D.M.D.

Provider Business Mailing Address
First Line	:	158 VILLAGE WALK DR
Second Line	:
City	:	HOLLY SPRINGS
State	:	NC
Zip	:	27540-7679
Country	:	US
Telephone Number	:	919-577-9009
Fax Number	:	919-762-1860

Provider Business Practice Location Address
First Line	:	158 VILLAGE WALK DR
Second Line	:	SUITE 205
City	:	HOLLY SPRINGS
State	:	NC
Zip	:	27540-7679
Country	:	US
Telephone Number	:	919-577-9009
Fax Number	:	919-762-1860

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

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	02/25/2014

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