Provider Demographics
NPI:1487609673
Name:GUNN, KAREN L (DDS)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:L
Last Name:GUNN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1880 LINCOLN
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48203-1273
Mailing Address - Country:US
Mailing Address - Phone:313-368-1754
Mailing Address - Fax:
Practice Address - Street 1:19207 SCHAEFER HWY
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235-1273
Practice Address - Country:US
Practice Address - Phone:313-861-2100
Practice Address - Fax:313-861-6513
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI137501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice