MEDICARE: KARL STEPHEN KLINAR 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	1223G0001X	General Practice Dentistry	2877	SC

General Provider Information

NPI Number	:	1366578502
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARL STEPHEN KLINAR D.M.D.

Provider Business Mailing Address
First Line	:	6320 SAINT ANDREWS RD
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29212-3126
Country	:	US
Telephone Number	:	803-772-5161
Fax Number	:	803-772-4441

Provider Business Practice Location Address
First Line	:	6320 SAINT ANDREWS RD
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29212-3126
Country	:	US
Telephone Number	:	803-772-5161
Fax Number	:	803-772-4441

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

Provider Enumeration Date	:	02/24/2007
Last Update Date	:	07/08/2007

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