Individual
CARLETTA ANNYSE DEMETREE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
323 LINCOLN BLVD, VENICE, CA 90291-2842
(310) 392-4103
Mailing address
1755 OCEAN AVE APT 510, SANTA MONICA, CA 90401-3620
(678) 468-0941
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
107002
CA
Other
Enumeration date
01/12/2022
Last updated
01/12/2022
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