Provider Demographics
NPI:1104495647
Name:KAREM DENTAL AND AESTHETICS
Entity type:Organization
Organization Name:KAREM DENTAL AND AESTHETICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TIN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:KAREM
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:502-633-3735
Mailing Address - Street 1:627 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40065-1131
Mailing Address - Country:US
Mailing Address - Phone:502-633-3735
Mailing Address - Fax:502-633-3737
Practice Address - Street 1:627 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:KY
Practice Address - Zip Code:40065-1131
Practice Address - Country:US
Practice Address - Phone:502-633-3735
Practice Address - Fax:502-633-3737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-19
Last Update Date:2021-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty