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General NPI Number Information
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NPI Number | 1548368038
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Entity Type | Individual
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Provider Name | KAREN KEMP-PROSTERMAN DDS
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Gender | Female
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 05/11/2021
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Provider Practice Location Address
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Address Line | 263 FARMINGTON AVE
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City | FARMINGTON
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State | CT
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Zip | 06030
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Country | US
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Telephone | 860-679-2207
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Fax | 860-679-1899
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Provider Business Mailing Address
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Address Line | 263 FARMINGTON AVE
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City | FARMINGTON
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State | CT
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Zip | 06030-3905
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Country | US
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Telephone | 860-679-2207
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Fax | 860-679-1899
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 000033-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 11044
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License Number State | CT
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