Provider Demographics
NPI:1598943789
Name:KARREN, DUSTIN DWIGHT (DMD,PC)
Entity Type:Individual
Prefix:DR
First Name:DUSTIN
Middle Name:DWIGHT
Last Name:KARREN
Suffix:
Gender:M
Credentials:DMD,PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 E BELL RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-6639
Mailing Address - Country:US
Mailing Address - Phone:602-482-3929
Mailing Address - Fax:602-867-0444
Practice Address - Street 1:702 E BELL RD
Practice Address - Street 2:SUITE 110
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-6639
Practice Address - Country:US
Practice Address - Phone:602-482-3929
Practice Address - Fax:602-867-0444
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-10
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ55571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice