Doctor Name: | KARA OPHEIM |
NPI Number: | 1306257134 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DDS |
License Number: | |
Business Practice Address: | 6226 14th Ave Kenosha, WI - 531434413 |
Business Phone Number: | 2626560044 |
Business Fax Number: | 2627643636 |
Mailing Address: | 625 57th St, Suite 700 KENOSHA |
State: | WI |
Postal Code: | 531404146 |
Phone Number: | 2627643622 |
Fax Number: | 2627643636 |
NPI Enumeration Date: | 05/14/2014 |
NPI Last Update Date: | 05/14/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |