Healthcare Provider Details

I. General information

NPI: 1053513283
Provider Name (Legal Business Name): KAREN ROSE KAMER DMD,MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8489 FISHERS CENTER DR
FISHERS IN
46038-2318
US

IV. Provider business mailing address

4128 WYTHE LN
INDIANAPOLIS IN
46250-4224
US

V. Phone/Fax

Practice location:
  • Phone: 317-578-2224
  • Fax:
Mailing address:
  • Phone: 317-750-3855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number12010821A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: