MEDICARE: DR. KAREN HOM 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	3333	NV

General Provider Information

NPI Number	:	1730225467
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAREN HOM D.D.S.

Provider Business Mailing Address
First Line	:	5920 MICHELLI CREST WAY
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89149-1239
Country	:	US
Telephone Number	:	702-227-6453
Fax Number	:	702-733-7466

Provider Business Practice Location Address
First Line	:	7425 W. AZURE
Second Line	:	SUITE 105
City	:	LAS VEGAS
State	:	NV
Zip	:	89130
Country	:	US
Telephone Number	:	702-227-6453
Fax Number	:	702-733-7466

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

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	07/08/2007

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