MEDICARE: KARINA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1164149027
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KARINA LLC

Provider Business Mailing Address
First Line	:	28160 OLD VILLAGE RD
Second Line	:
City	:	MECHANICSVILLE
State	:	MD
Zip	:	20659-4289
Country	:	US
Telephone Number	:	410-610-4922
Fax Number	:	866-219-6469

Provider Business Practice Location Address
First Line	:	28160 OLD VILLAGE RD
Second Line	:
City	:	MECHANICSVILLE
State	:	MD
Zip	:	20659-4289
Country	:	US
Telephone Number	:	410-610-4922
Fax Number	:	866-219-6469

Authorized Official
Title or Position	:	CO-OWNER DENTIST
Name	:	DR. KARA MARIE MCCRAY DEMER
Credential	:	DDS
Telephone Number	:	410-610-4922

Provider Enumeration Date	:	10/21/2022
Last Update Date	:	10/21/2022

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Directions to “KARINA LLC ” Practice Location

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