Healthcare Provider Details
I. General information
NPI: 1992723357
Provider Name (Legal Business Name): DOUGLAS D. KARWOSKI D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
901 MEDICAL CENTER DR. SUITE 200
DAYTON NV
89403
US
IV. Provider business mailing address
901 MEDICAL CENTER DR. SUITE 200
DAYTON NV
89403
US
V. Phone/Fax
- Phone: 775-246-7122
- Fax: 775-246-7123
- Phone: 775-246-7122
- Fax: 775-246-7123
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | 4278 |
| License Number State | NV |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: