Provider Demographics
NPI:1437388253
Name:ARREDONDO, CARLO MARCEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:CARLO
Middle Name:MARCEL
Last Name:ARREDONDO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:CARLO
Other - Middle Name:MARCEL
Other - Last Name:ARREDONDO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:1725 SW CHANDLER AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-3248
Mailing Address - Country:US
Mailing Address - Phone:541-241-1299
Mailing Address - Fax:541-797-6086
Practice Address - Street 1:1725 SW CHANDLER AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3248
Practice Address - Country:US
Practice Address - Phone:541-241-1299
Practice Address - Fax:541-797-6086
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-14
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD8423122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist