Individual
DR. KAREN NADINE CLISTER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1220 E NAPIER AVE, BENTON HARBOR, MI 49022-3900
(269) 925-2113
(269) 925-2191
Mailing address
1220 E NAPIER AVE, BENTON HARBOR, MI 49022-3900
(269) 925-2113
(269) 925-2191
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
14250
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014250
BCBS PROVIDER ID
MI
01
—
14250
MICHIGAN LICENSE NUMBER
MI
05
—
4230680
—
MI
Enumeration date
11/03/2005
Last updated
07/09/2007
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