Provider Demographics
NPI:1063687119
Name:KAREN M. MEGA, DMD INC.
Entity Type:Organization
Organization Name:KAREN M. MEGA, DMD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:M
Authorized Official - Last Name:MEGA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:401-781-2772
Mailing Address - Street 1:567 RESERVOIR AVE
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02910-1621
Mailing Address - Country:US
Mailing Address - Phone:401-781-2772
Mailing Address - Fax:401-781-7270
Practice Address - Street 1:567 RESERVOIR AVE
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02910-1621
Practice Address - Country:US
Practice Address - Phone:401-781-2772
Practice Address - Fax:401-781-7270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental