Provider Demographics
NPI:1063541225
Name:KARMO, ATHEER NORI (DDS)
Entity type:Individual
Prefix:MR
First Name:ATHEER
Middle Name:NORI
Last Name:KARMO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 E 12 MILE RD
Mailing Address - Street 2:FAMILY CARE DENTISTRY
Mailing Address - City:MADISON HTS
Mailing Address - State:MI
Mailing Address - Zip Code:48071
Mailing Address - Country:US
Mailing Address - Phone:248-541-4321
Mailing Address - Fax:248-541-9887
Practice Address - Street 1:1200 E 12 MILE RD
Practice Address - Street 2:FAMILY CARE DENTISTRY
Practice Address - City:MADISON HTS
Practice Address - State:MI
Practice Address - Zip Code:48071
Practice Address - Country:US
Practice Address - Phone:248-541-4321
Practice Address - Fax:248-541-9887
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010166101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3106890Medicaid