Provider Demographics
NPI:1679662977
Name:CARNICE, ANNABELLE R (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANNABELLE
Middle Name:R
Last Name:CARNICE
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 1:2810 CROW CANYON RD STE 202
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-1670
Mailing Address - Country:US
Mailing Address - Phone:925-552-0444
Mailing Address - Fax:925-552-0418
Practice Address - Street 1:2810 CROW CANYON RD STE 202
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-1670
Practice Address - Country:US
Practice Address - Phone:925-552-0444
Practice Address - Fax:925-552-0418
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43120122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist