Provider Demographics
NPI:1104205772
Name:DELANEY, KAREN JO (DDS)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:JO
Last Name:DELANEY
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 1:254 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:CALAIS
Mailing Address - State:ME
Mailing Address - Zip Code:04619-1322
Mailing Address - Country:US
Mailing Address - Phone:207-454-2350
Mailing Address - Fax:207-454-2897
Practice Address - Street 1:399 MAIN ST
Practice Address - Street 2:
Practice Address - City:CALAIS
Practice Address - State:ME
Practice Address - Zip Code:04619-1859
Practice Address - Country:US
Practice Address - Phone:207-454-2350
Practice Address - Fax:207-454-2897
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-28
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDEN4422122300000X, 1223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223D0001XDental ProvidersDentistDental Public Health