Provider Demographics
NPI:1003927625
Name:KARKOW, MARY K (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:K
Last Name:KARKOW
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N14W23833 STONE RIDGE DR
Mailing Address - Street 2:SUITE 240
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-1157
Mailing Address - Country:US
Mailing Address - Phone:262-232-8777
Mailing Address - Fax:
Practice Address - Street 1:N14W23833 STONE RIDGE DR
Practice Address - Street 2:SUITE 240
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-1157
Practice Address - Country:US
Practice Address - Phone:262-232-8777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4550151223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIK400216580Medicare UPIN