Organization
RAYMOND E CARPENTER D D S INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAYMOND E CARPENTER D D S (OWNER)
(858) 775-6361
Entity
Organization
Contact information
Practice address
4320 GENESEE AVE STE 207, SAN DIEGO, CA 92117-4900
(858) 775-6361
Mailing address
4320 GENESEE AVE STE 207, SAN DIEGO, CA 92117-4900
(858) 775-6361
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
1223X2210X
Orofacial Pain Dentistry
—
—
Other
Enumeration date
01/18/2024
Last updated
04/18/2024
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