Provider Demographics
NPI:1104821354
Name:CARTER, PARVIN S (DDS, MAGD)
Entity type:Individual
Prefix:DR
First Name:PARVIN
Middle Name:S
Last Name:CARTER
Suffix:
Gender:F
Credentials:DDS, MAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1667 HILLTOP DR
Mailing Address - Street 2:STE 13
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-0240
Mailing Address - Country:US
Mailing Address - Phone:530-917-6628
Mailing Address - Fax:530-917-6628
Practice Address - Street 1:4268 BOSTON AVE
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-5814
Practice Address - Country:US
Practice Address - Phone:530-917-6628
Practice Address - Fax:530-917-6628
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN83761223G0001X
CA531611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice