# RAYMOND E CARPENTER D D S INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780445601
- **Authorized official:** RAYMOND E CARPENTER D D S (OWNER)
- **Authorized official phone:** (858) 775-6361

## Contact information

- **Practice address:** 4320 GENESEE AVE STE 207, SAN DIEGO, CA 92117-4900
- **Practice address phone:** (858) 775-6361
- **Mailing address:** 4320 GENESEE AVE STE 207, SAN DIEGO, CA 92117-4900
- **Mailing address phone:** (858) 775-6361

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0700X | Prosthodontics | — | NULL | — |
| 1223P0700X | Prosthodontics | — | — | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |
| 1223X2210X | Orofacial Pain Dentistry | — | NULL | — |
| 1223X2210X | Orofacial Pain Dentistry | — | — | — |

## Other

- **Enumeration date:** 01/18/2024
- **Last updated:** 04/18/2024