Individual
DR. KAREN MICHELLE IMBODEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
326 N ROSSER ST, FORREST CITY, AR 72335
(870) 633-4591
(870) 633-8560
Mailing address
326 N ROSSER ST, FORREST CITY, AR 72335
(870) 633-4591
(870) 633-8560
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3056
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
124517608
—
AR
01
—
71-0770496
TAX ID
AR
01
—
710770496
DELTA DENTAL
AR
01
—
BLUE CROSS BS FEDERA
58814
AR
01
—
UNITED CONCORDIA
001434036
AR
Enumeration date
10/02/2006
Last updated
07/08/2007
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