Provider Demographics
NPI:1144216037
Name:MONT, KARINA (DMD)
Entity type:Individual
Prefix:DR
First Name:KARINA
Middle Name:
Last Name:MONT
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:VALLE VERDE #5 MADRID
Mailing Address - Street 2:
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659-2604
Mailing Address - Country:US
Mailing Address - Phone:787-820-3250
Mailing Address - Fax:
Practice Address - Street 1:ROAD #2, KM. 84.7
Practice Address - Street 2:CARRIZALES
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659
Practice Address - Country:US
Practice Address - Phone:787-820-3355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-26
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRD02636122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist