Healthcare Provider Details

I. General information

NPI: 1992092969
Provider Name (Legal Business Name): LITSA KARAOUZAS DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2011
Last Update Date: 02/18/2022
Certification Date: 02/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

806 TUURI PL
FLINT MI
48503-2465
US

IV. Provider business mailing address

806 TUURI PL
FLINT MI
48503-2465
US

V. Phone/Fax

Practice location:
  • Phone: 810-768-7583
  • Fax: 810-768-7584
Mailing address:
  • Phone: 810-768-7583
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number2901019356
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: