Provider Demographics
NPI:1912008517
Name:KARMAZIN, COREY S (DDS)
Entity Type:Individual
Prefix:DR
First Name:COREY
Middle Name:S
Last Name:KARMAZIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3220 W 57TH ST
Mailing Address - Street 2:SUITE 115
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-3145
Mailing Address - Country:US
Mailing Address - Phone:605-323-1320
Mailing Address - Fax:605-323-1329
Practice Address - Street 1:3220 W 57TH ST
Practice Address - Street 2:SUITE 115
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-3145
Practice Address - Country:US
Practice Address - Phone:605-323-1320
Practice Address - Fax:605-323-1329
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDM959122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist