Provider Demographics
NPI:1043611825
Name:KARLIN PETRACEK PLLC
Entity Type:Organization
Organization Name:KARLIN PETRACEK PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SAIDE KARLIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-933-2420
Mailing Address - Street 1:13402 W COAL MINE AVE
Mailing Address - Street 2:SUITE 270
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-5407
Mailing Address - Country:US
Mailing Address - Phone:303-933-2420
Mailing Address - Fax:
Practice Address - Street 1:13402 W COAL MINE AVE
Practice Address - Street 2:SUITE 270
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-5407
Practice Address - Country:US
Practice Address - Phone:303-933-2420
Practice Address - Fax:303-484-3662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-11
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO92691223G0001X
CO89251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty