Individual
KARLY VERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1120 W SOUTH BOULDER RD STE 204, LAFAYETTE, CO 80026-8952
(631) 275-7082
Mailing address
18 DORADELL DR, HOLBROOK, NY 11741-1206
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DEN.00205080
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/10/2021
Last updated
08/17/2023
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