Provider Demographics
NPI:1922300151
Name:CARPENTER ESTEY, ERIN MARIE (DDS)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:MARIE
Last Name:CARPENTER ESTEY
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 1:1806 ORANGE TREE LN
Mailing Address - Street 2:SUITE B
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-4569
Mailing Address - Country:US
Mailing Address - Phone:909-335-1166
Mailing Address - Fax:909-335-1327
Practice Address - Street 1:1806 ORANGE TREE LN
Practice Address - Street 2:SUITE B
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-4569
Practice Address - Country:US
Practice Address - Phone:909-335-1166
Practice Address - Fax:909-335-1327
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-19
Last Update Date:2017-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45230122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist