Provider Demographics
NPI:1801017546
Name:KAUFMANN, CARL CHRISTIAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:CHRISTIAN
Last Name:KAUFMANN
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 1:210 HEINLEN ST
Mailing Address - Street 2:
Mailing Address - City:LEMOORE
Mailing Address - State:CA
Mailing Address - Zip Code:93245-2947
Mailing Address - Country:US
Mailing Address - Phone:559-924-5353
Mailing Address - Fax:559-924-5366
Practice Address - Street 1:210 HEINLEN ST
Practice Address - Street 2:
Practice Address - City:LEMOORE
Practice Address - State:CA
Practice Address - Zip Code:93245-2947
Practice Address - Country:US
Practice Address - Phone:559-924-5353
Practice Address - Fax:559-924-5366
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD22511122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist