Provider Demographics
NPI:1447771043
Name:KARSKI-SPOKANE ORTHODONTICS PC
Entity type:Organization
Organization Name:KARSKI-SPOKANE ORTHODONTICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:KARSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MDS
Authorized Official - Phone:724-991-0103
Mailing Address - Street 1:141 HIDDEN SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:RENFREW
Mailing Address - State:PA
Mailing Address - Zip Code:16053-8104
Mailing Address - Country:US
Mailing Address - Phone:724-991-0103
Mailing Address - Fax:
Practice Address - Street 1:659 CASTLE CREEK DRIVE EXT
Practice Address - Street 2:
Practice Address - City:SEVEN FIELDS
Practice Address - State:PA
Practice Address - Zip Code:16046-7872
Practice Address - Country:US
Practice Address - Phone:724-991-0103
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-05
Last Update Date:2017-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS040230261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1029661480002Medicaid
PA1029661480003Medicaid