Provider Demographics
NPI:1235322652
Name:KRITIKOS-KARALIS, KONSTANTINA (DMD)
Entity Type:Individual
Prefix:DR
First Name:KONSTANTINA
Middle Name:
Last Name:KRITIKOS-KARALIS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:DINA
Other - Middle Name:
Other - Last Name:K-KARALIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:117 N FURNACE ST
Mailing Address - Street 2:
Mailing Address - City:BIRDSBORO
Mailing Address - State:PA
Mailing Address - Zip Code:19508-2022
Mailing Address - Country:US
Mailing Address - Phone:610-582-1594
Mailing Address - Fax:610-404-7818
Practice Address - Street 1:117 N FURNACE ST
Practice Address - Street 2:
Practice Address - City:BIRDSBORO
Practice Address - State:PA
Practice Address - Zip Code:19508-2022
Practice Address - Country:US
Practice Address - Phone:610-582-1594
Practice Address - Fax:610-404-7818
Is Sole Proprietor?:No
Enumeration Date:2007-08-20
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS029973L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice