Provider Demographics
NPI:1770948812
Name:KARMA PRIME LLC
Entity type:Organization
Organization Name:KARMA PRIME LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KALPESHKUMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:THAKKAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-902-5327
Mailing Address - Street 1:625 W CROSSVILLE RD
Mailing Address - Street 2:STE 200
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-7503
Mailing Address - Country:US
Mailing Address - Phone:404-902-5327
Mailing Address - Fax:
Practice Address - Street 1:600 CHASTAIN RD NW
Practice Address - Street 2:STE 426 - ICLEAR ORTHODONTICS
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-3004
Practice Address - Country:US
Practice Address - Phone:404-902-5327
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-16
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty