Provider Demographics
NPI:1457480337
Name:GERMAIN, CAROLE
Entity Type:Individual
Prefix:DR
First Name:CAROLE
Middle Name:
Last Name:GERMAIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1313 NOSTRAND AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-2237
Mailing Address - Country:US
Mailing Address - Phone:718-826-0251
Mailing Address - Fax:718-826-0302
Practice Address - Street 1:1313 NOSTRAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-2237
Practice Address - Country:US
Practice Address - Phone:718-826-0251
Practice Address - Fax:718-826-0302
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0432991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice