Provider Demographics
NPI:1912915083
Name:GASKINS, KARLIE ANN (DDS)
Entity Type:Individual
Prefix:DR
First Name:KARLIE
Middle Name:ANN
Last Name:GASKINS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4586 SE MILE HILL DR STE A101
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98366-3909
Mailing Address - Country:US
Mailing Address - Phone:360-769-0667
Mailing Address - Fax:360-769-0675
Practice Address - Street 1:4586 SE MILE HILL DR STE A101
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-3909
Practice Address - Country:US
Practice Address - Phone:360-769-0667
Practice Address - Fax:360-769-0675
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD8160122300000X
WA0009311122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist