Provider Demographics
NPI:1306971205
Name:UM, KARAM
Entity type:Individual
Prefix:
First Name:KARAM
Middle Name:
Last Name:UM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4747 N 1ST ST STE 174
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-0517
Mailing Address - Country:US
Mailing Address - Phone:559-493-5530
Mailing Address - Fax:559-493-5219
Practice Address - Street 1:4747 N. FIRST ST. STE. #174
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-0517
Practice Address - Country:US
Practice Address - Phone:559-493-5530
Practice Address - Fax:559-493-5219
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA498231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice