Provider Demographics
NPI:1639282759
Name:COMPEAN, CARLOS G (DDS)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:G
Last Name:COMPEAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1485 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-4466
Mailing Address - Country:US
Mailing Address - Phone:951-784-4441
Mailing Address - Fax:951-784-4030
Practice Address - Street 1:2860 MICHELLE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92606-1009
Practice Address - Country:US
Practice Address - Phone:714-508-3600
Practice Address - Fax:714-368-2092
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA291271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice