Provider Demographics
NPI:1053513283
Name:KAMER, KAREN ROSE (DMD,MS)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:ROSE
Last Name:KAMER
Suffix:
Gender:F
Credentials:DMD,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4128 WYTHE LN
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-4224
Mailing Address - Country:US
Mailing Address - Phone:317-750-3855
Mailing Address - Fax:
Practice Address - Street 1:8489 FISHERS CENTER DR
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-2318
Practice Address - Country:US
Practice Address - Phone:317-578-2224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12010821A1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics