Provider Demographics
NPI:1922125566
Name:CHRISTIAN M. KARAVOLAS, D.D.S., P.C.
Entity Type:Organization
Organization Name:CHRISTIAN M. KARAVOLAS, D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:KARAVOLAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:781-647-0804
Mailing Address - Street 1:116 BIRD ST
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02492-4334
Mailing Address - Country:US
Mailing Address - Phone:781-433-0711
Mailing Address - Fax:781-647-6730
Practice Address - Street 1:20 HOPE AVE
Practice Address - Street 2:SUITE 306
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02453-2721
Practice Address - Country:US
Practice Address - Phone:781-647-0804
Practice Address - Fax:781-647-6730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA185481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty