Provider Demographics
NPI:1457516700
Name:ROMAN, KARLA Z (DMD)
Entity Type:Individual
Prefix:DR
First Name:KARLA
Middle Name:Z
Last Name:ROMAN
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 1:2773 HARRIS ST
Mailing Address - Street 2:STE B
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95503-4866
Mailing Address - Country:US
Mailing Address - Phone:707-444-0488
Mailing Address - Fax:
Practice Address - Street 1:2773 HARRIS ST
Practice Address - Street 2:STE B
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95503-4866
Practice Address - Country:US
Practice Address - Phone:707-444-0488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-25
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57295122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist