Provider Demographics
NPI:1174639785
Name:CARTER, KIMBERLY HSU (DMD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:HSU
Last Name:CARTER
Suffix:
Gender:F
Credentials:DMD
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Mailing Address - Street 1:22342 AVENIDA EMPRESA
Mailing Address - Street 2:SUITE 285
Mailing Address - City:RANCHO SANTA MARGARITA
Mailing Address - State:CA
Mailing Address - Zip Code:92688-2140
Mailing Address - Country:US
Mailing Address - Phone:949-766-8800
Mailing Address - Fax:949-766-8899
Practice Address - Street 1:22342 AVENIDA EMPRESA
Practice Address - Street 2:SUITE 285
Practice Address - City:RANCHO SANTA MARGARITA
Practice Address - State:CA
Practice Address - Zip Code:92688-2140
Practice Address - Country:US
Practice Address - Phone:949-766-8800
Practice Address - Fax:949-766-8899
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA484611223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics