Provider Demographics
NPI:1396885505
Name:KARAZULAS, CONSTANTINE P (DDS)
Entity type:Individual
Prefix:DR
First Name:CONSTANTINE
Middle Name:P
Last Name:KARAZULAS
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 1:38 ALDEN ST
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-6464
Mailing Address - Country:US
Mailing Address - Phone:203-319-9456
Mailing Address - Fax:
Practice Address - Street 1:2595 PARK AVE
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06604-1359
Practice Address - Country:US
Practice Address - Phone:203-366-2720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT33381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice