Organization Name: | KARIM E . BERTY DMD MD PC |
NPI Number: | 1013219476 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KARIM E BERTY (PRESIDENT) |
Mailing Address: | 100 Amesbury St Ste 112 Lawrence |
State: | MA US |
Postal Code: | 018401321 |
Phone Number: | 9784700330 |
Fax Number: | |
NPI Enumeration Date: | 11/17/2010 |
NPI Last Update Date: | 06/27/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 204E00000X |
License Number: | DN-21685 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Oral & Maxillofacial Surgery |
Taxonomy Specialization: | |
Taxonomy Definition: |