Provider Demographics
NPI:1295991263
Name:KARR, NICOLE ALICIA (DMD)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:ALICIA
Last Name:KARR
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 1:1770 E LAMBERT RD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-8005
Mailing Address - Country:US
Mailing Address - Phone:714-529-9029
Mailing Address - Fax:
Practice Address - Street 1:1770 E LAMBERT RD
Practice Address - Street 2:SUITE 230
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-8005
Practice Address - Country:US
Practice Address - Phone:714-529-9029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-30
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD91161223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics