Provider Demographics
NPI:1780026278
Name:DAVID P. CARTAGO, DDS, II INC
Entity Type:Organization
Organization Name:DAVID P. CARTAGO, DDS, II INC
Other - Org Name:PERFECT SMILES FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:P
Authorized Official - Last Name:CARTAGO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:925-833-8702
Mailing Address - Street 1:9260 ALCOSTA BLVD STE B10
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-4134
Mailing Address - Country:US
Mailing Address - Phone:925-833-8702
Mailing Address - Fax:
Practice Address - Street 1:9260 ALCOSTA BLVD STE B10
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-4134
Practice Address - Country:US
Practice Address - Phone:925-833-8702
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-24
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55561122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty