Provider Demographics
NPI:1215099775
Name:MINSK-KARELLOS, LAURA (DMD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:
Last Name:MINSK-KARELLOS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:MINSK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:801 YALE AVE
Mailing Address - Street 2:SUITE 619
Mailing Address - City:SWARTHMORE
Mailing Address - State:PA
Mailing Address - Zip Code:19081-1808
Mailing Address - Country:US
Mailing Address - Phone:610-892-1120
Mailing Address - Fax:
Practice Address - Street 1:801 YALE AVE
Practice Address - Street 2:SUITE 619
Practice Address - City:SWARTHMORE
Practice Address - State:PA
Practice Address - Zip Code:19081-1808
Practice Address - Country:US
Practice Address - Phone:610-892-1120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS028124L1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics