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General NPI Number Information
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NPI Number | 1316137607
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Entity Type | Organization
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Legal Business Name | C. KARKIA, D.D.S. , M.S.A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 08/01/2007
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Last Update Date | 08/01/2007
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Provider Practice Location Address
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Address Line | 135 KELLER ST SUITE E
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City | PETALUMA
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State | CA
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Zip | 94952-2943
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Country | US
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Telephone | 707-789-9399
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Fax |
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Provider Business Mailing Address
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Address Line | 135 KELLER ST SUITE E
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City | PETALUMA
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State | CA
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Zip | 94952-2943
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Country | US
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Telephone | 707-789-9399
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CLAUDIA KARKIA
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Credential | D. D.S.
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Telephone | 707-789-9399
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 49766
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License Number State | CA
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