Provider Demographics
NPI:1942533088
Name:REID, KAREN CAROLE (DMD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:CAROLE
Last Name:REID
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4263 NW 29TH WAY
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-5805
Mailing Address - Country:US
Mailing Address - Phone:954-465-5591
Mailing Address - Fax:
Practice Address - Street 1:4263 NW 29TH WAY
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-5805
Practice Address - Country:US
Practice Address - Phone:954-465-5591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-08
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN17197122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist