Provider Demographics
NPI:1174147045
Name:KATIE J. KARZEN, A DENTAL CORPORATION
Entity type:Organization
Organization Name:KATIE J. KARZEN, A DENTAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:KARZEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-414-0001
Mailing Address - Street 1:10800 PARAMOUNT BLVD STE 304
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-3324
Mailing Address - Country:US
Mailing Address - Phone:562-414-0001
Mailing Address - Fax:562-381-2771
Practice Address - Street 1:10800 PARAMOUNT BLVD STE 304
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-3324
Practice Address - Country:US
Practice Address - Phone:562-414-0001
Practice Address - Fax:562-381-2771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-05
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental