Provider Demographics
NPI:1205816527
Name:STEWART, KAREN-LEE JONES (DDS)
Entity Type:Individual
Prefix:DR
First Name:KAREN-LEE
Middle Name:JONES
Last Name:STEWART
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:KAREN
Other - Middle Name:LEE
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:2390 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-6110
Mailing Address - Country:US
Mailing Address - Phone:734-665-9104
Mailing Address - Fax:734-665-4055
Practice Address - Street 1:2390 S STATE ST
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-6110
Practice Address - Country:US
Practice Address - Phone:734-665-9104
Practice Address - Fax:734-665-4055
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901016591122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist