Provider Demographics
NPI:1104969575
Name:AVILA, KAREN FRANCISCO (DDS)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:FRANCISCO
Last Name:AVILA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:325 S HIGHLAND AVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:BRIARCLIFF MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10510-2096
Mailing Address - Country:US
Mailing Address - Phone:914-236-3136
Mailing Address - Fax:914-236-3137
Practice Address - Street 1:325 S HIGHLAND AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:BRIARCLIFF MANOR
Practice Address - State:NY
Practice Address - Zip Code:10510-2096
Practice Address - Country:US
Practice Address - Phone:914-236-3136
Practice Address - Fax:914-236-3137
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2015-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0466921223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02162696Medicaid
NYU86223Medicare UPIN