Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 30658 | TX |
NPI | 1043403173 |
---|---|
Provider Name | Mr. Benjamin Dale Karren |
First Address | Temple, TX 76502-1849 |
Second Address | Temple, TX 76502-1849 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2007 |
Last Update Date | 16/04/2015 |