Provider Demographics
NPI:1922230499
Name:RAINEY, KAREN B (DMD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:B
Last Name:RAINEY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 FAIRFIELD DR
Mailing Address - Street 2:
Mailing Address - City:HORSEHEADS
Mailing Address - State:NY
Mailing Address - Zip Code:14845-2287
Mailing Address - Country:US
Mailing Address - Phone:607-739-9172
Mailing Address - Fax:
Practice Address - Street 1:1 PROGRESS PLZ
Practice Address - Street 2:SUITE 6
Practice Address - City:TOWANDA
Practice Address - State:PA
Practice Address - Zip Code:18848-1656
Practice Address - Country:US
Practice Address - Phone:570-268-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-18
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS027223L1223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice