Provider Demographics
NPI:1255321709
Name:FORSTER, KARL M (DDS)
Entity Type:Individual
Prefix:
First Name:KARL
Middle Name:M
Last Name:FORSTER
Suffix:
Gender:M
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:PO BOX 518
Mailing Address - Street 2:
Mailing Address - City:MUNFORDVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42765-0518
Mailing Address - Country:US
Mailing Address - Phone:270-524-3008
Mailing Address - Fax:270-524-9561
Practice Address - Street 1:309 CALDWELL ST
Practice Address - Street 2:
Practice Address - City:MUNFORDVILLE
Practice Address - State:KY
Practice Address - Zip Code:42765-9066
Practice Address - Country:US
Practice Address - Phone:270-524-3008
Practice Address - Fax:270-524-9561
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4889122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY60048899Medicaid