Provider Demographics
NPI:1376537258
Name:MUEHLENPFORT, CARRIE M (DDS)
Entity Type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:M
Last Name:MUEHLENPFORT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 RIVER ROCK CT
Mailing Address - Street 2:
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92071-6940
Mailing Address - Country:US
Mailing Address - Phone:760-830-7054
Mailing Address - Fax:760-830-7074
Practice Address - Street 1:290 PALMS MARINE CORPS BASE
Practice Address - Street 2:23 DENTAL COMPANY
Practice Address - City:29 PALMS
Practice Address - State:CA
Practice Address - Zip Code:92278
Practice Address - Country:US
Practice Address - Phone:760-830-7054
Practice Address - Fax:760-830-7074
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA525181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice