Individual
INTI MENDOZA CARRASCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1257 BROAD ST, SUMTER, SC 29150-1973
(803) 773-1355
Mailing address
8210 FOUNTAIN AVE # 203, WEST HOLLYWOOD, CA 90046-3713
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11225
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/23/2025
Last updated
08/25/2025
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