Provider Demographics
NPI:1932239530
Name:THOMAS, KAREN (RDH)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 LAINE CT
Mailing Address - Street 2:
Mailing Address - City:APALACHIN
Mailing Address - State:NY
Mailing Address - Zip Code:13732-3828
Mailing Address - Country:US
Mailing Address - Phone:607-625-2556
Mailing Address - Fax:
Practice Address - Street 1:249 GLENWOOD RD
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13905-1603
Practice Address - Country:US
Practice Address - Phone:607-770-0366
Practice Address - Fax:607-770-0354
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0223281124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist