Provider Demographics
NPI:1538134044
Name:BOBER, KAREN M (DDS)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:M
Last Name:BOBER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5007 COUNCIL POINTE RD
Mailing Address - Street 2:
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51501-8557
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:300 W BROADWAY
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503-9045
Practice Address - Country:US
Practice Address - Phone:712-325-1990
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE6387122300000X
IA081691223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered122300000XDental ProvidersDentist
Not Answered1223D0001XDental ProvidersDentistDental Public Health