Healthcare Provider Details

I. General information

NPI: 1821091570
Provider Name (Legal Business Name): JOHN DAVID KARABASZ DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

Provider Other Name: JACK KARABASZ DMD

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1251 S CEDAR CREST BLVD STE 306
ALLENTOWN PA
18103-6205
US

IV. Provider business mailing address

1251 S CEDAR CREST BLVD STE 306
ALLENTOWN PA
18103-6205
US

V. Phone/Fax

Practice location:
  • Phone: 610-770-0210
  • Fax: 610-770-9876
Mailing address:
  • Phone: 610-770-0210
  • Fax: 610-770-9876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License NumberDS019478L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: