Provider Demographics
NPI:1639221807
Name:CARACO, ROBERT (DDS)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:CARACO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5370 HOLLISTER AVENUE
Mailing Address - Street 2:SUITE F
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93111-2303
Mailing Address - Country:US
Mailing Address - Phone:805-967-0479
Mailing Address - Fax:805-967-8829
Practice Address - Street 1:5370 HOLLISTER AVENUE
Practice Address - Street 2:SUITE F
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93111-2303
Practice Address - Country:US
Practice Address - Phone:805-967-0479
Practice Address - Fax:805-967-8829
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA268171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice