MEDICARE: DR. KAREN ANDERSON HECK 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	1223G0001X	General Practice Dentistry	9155	MN

General Provider Information

NPI Number	:	1194813071
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAREN ANDERSON HECK D.D.S.

Provider Business Mailing Address
First Line	:	102 1ST AVE SW
Second Line	:	PO BOX 588
City	:	CHISHOLM
State	:	MN
Zip	:	55719-1824
Country	:	US
Telephone Number	:	218-254-4311
Fax Number	:

Provider Business Practice Location Address
First Line	:	102 1ST AVE SW
Second Line	:
City	:	CHISHOLM
State	:	MN
Zip	:	55719-1824
Country	:	US
Telephone Number	:	218-254-4311
Fax Number	:

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

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	07/08/2007

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