Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 22237 | TX |
NPI | 1053416271 |
---|---|
Provider Name | Dr. Karina Marr |
First Address | Dallas, TX 75231-5713 |
Second Address | Dallas, TX 75237-2632 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2006 |
Last Update Date | 26/07/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1773608 | (05) | TX |