Provider Demographics
NPI:1013219476
Name:KARIM E . BERTY DMD MD PC
Entity Type:Organization
Organization Name:KARIM E . BERTY DMD MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KARIM
Authorized Official - Middle Name:E
Authorized Official - Last Name:BERTY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MD
Authorized Official - Phone:978-470-0330
Mailing Address - Street 1:100 AMESBURY ST STE 112
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01840-1321
Mailing Address - Country:US
Mailing Address - Phone:978-470-0330
Mailing Address - Fax:
Practice Address - Street 1:100 AMESBURY ST STE 112
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01840-1321
Practice Address - Country:US
Practice Address - Phone:978-470-0330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-17
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN-21685204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Single Specialty