Provider Demographics
NPI:1710902663
Name:CARPIO, MARIA L (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:L
Last Name:CARPIO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1572 SYCAMORE AVE STE. G
Mailing Address - Street 2:
Mailing Address - City:HERCULES
Mailing Address - State:CA
Mailing Address - Zip Code:94547-1772
Mailing Address - Country:US
Mailing Address - Phone:510-799-9345
Mailing Address - Fax:510-799-3913
Practice Address - Street 1:1572 SYCAMORE AVE STE G
Practice Address - Street 2:
Practice Address - City:HERCULES
Practice Address - State:CA
Practice Address - Zip Code:94547-1772
Practice Address - Country:US
Practice Address - Phone:510-799-9345
Practice Address - Fax:510-799-3913
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40552122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist