Provider Demographics
NPI:1669649497
Name:TERRY KARNOVSKY DDS PC
Entity Type:Organization
Organization Name:TERRY KARNOVSKY DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:KARNOVSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-527-6200
Mailing Address - Street 1:146-32 243RD ST
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11422
Mailing Address - Country:US
Mailing Address - Phone:718-527-6200
Mailing Address - Fax:718-525-7829
Practice Address - Street 1:146-32 243RD ST
Practice Address - Street 2:TERRY KARNOVSKY DDS PC
Practice Address - City:ROSEDALE
Practice Address - State:NY
Practice Address - Zip Code:11422
Practice Address - Country:US
Practice Address - Phone:718-527-6200
Practice Address - Fax:718-525-7829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0286461122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty