Provider Demographics
NPI:1326164682
Name:KARCH, EDWIN ANTHONY JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:ANTHONY
Last Name:KARCH
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:8236 GOLDENROD CT
Mailing Address - Street 2:
Mailing Address - City:FOX LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60020-0913
Mailing Address - Country:US
Mailing Address - Phone:847-587-4123
Mailing Address - Fax:630-837-8723
Practice Address - Street 1:1601 TANGLEWOOD AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:HANOVER PARK
Practice Address - State:IL
Practice Address - Zip Code:60133-3381
Practice Address - Country:US
Practice Address - Phone:630-837-8704
Practice Address - Fax:630-837-8723
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice