Healthcare Provider Details

I. General information

NPI: 1225131881
Provider Name (Legal Business Name): EVA A KARMO DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 08/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4607 W. VERNOR HWY
DETROIT MI
48209
US

IV. Provider business mailing address

4607 W. VERNOR HWY
DETROIT MI
48209
US

V. Phone/Fax

Practice location:
  • Phone: 313-554-3300
  • Fax: 313-554-3303
Mailing address:
  • Phone: 313-554-3300
  • Fax: 313-554-3303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2901017881
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: