Provider Demographics
NPI:1639296460
Name:MANCINI, KAREN ANN (DMD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:ANN
Last Name:MANCINI
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 1:680 LOCUST POINT RD
Mailing Address - Street 2:
Mailing Address - City:RUMSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07760-2322
Mailing Address - Country:US
Mailing Address - Phone:732-291-8040
Mailing Address - Fax:
Practice Address - Street 1:105 ELMORA AVE
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07202-1614
Practice Address - Country:US
Practice Address - Phone:908-354-1490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI-16502122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist