Provider Demographics
NPI:1417975327
Name:COELLO, KAREN K (DMD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:K
Last Name:COELLO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 S DIXIE HWY
Mailing Address - Street 2:SUITE103
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-7452
Mailing Address - Country:US
Mailing Address - Phone:561-368-4057
Mailing Address - Fax:561-368-3405
Practice Address - Street 1:1700 S DIXIE HWY
Practice Address - Street 2:SUITE 103
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-7452
Practice Address - Country:US
Practice Address - Phone:561-368-4057
Practice Address - Fax:561-368-3405
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL109271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice