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Individual
KAREN POTACZEK
Active
Individual
KAREN POTACZEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
08697
IA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
6012-15
WI
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
08697
IA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
6012-15
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1700089513
—
IA
05
—
1700089513
—
MN
Enumeration date
06/08/2007
Last updated
03/23/2026
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