Provider Demographics
NPI:1659492718
Name:KARBAKHSCH, MINOU (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:MINOU
Middle Name:
Last Name:KARBAKHSCH
Suffix:
Gender:F
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2302 SO. UNION AVE.
Mailing Address - Street 2:SUITE C-22
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405
Mailing Address - Country:US
Mailing Address - Phone:253-752-6336
Mailing Address - Fax:253-752-5655
Practice Address - Street 1:2302 SO. UNION AVE.
Practice Address - Street 2:SUITE C-22
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405
Practice Address - Country:US
Practice Address - Phone:253-752-6336
Practice Address - Fax:253-752-5655
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA85791223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics