Provider Demographics
NPI:1689794042
Name:KARASEK, ROBERT D (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:D
Last Name:KARASEK
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 LAGOON BLVD
Mailing Address - Street 2:
Mailing Address - City:BRIGANTINE
Mailing Address - State:NJ
Mailing Address - Zip Code:08203-1221
Mailing Address - Country:US
Mailing Address - Phone:908-247-0472
Mailing Address - Fax:609-645-0162
Practice Address - Street 1:50 W BLACK HORSE PIKE
Practice Address - Street 2:
Practice Address - City:PLEASANTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08232-2645
Practice Address - Country:US
Practice Address - Phone:609-641-1065
Practice Address - Fax:609-645-0162
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI017237122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist