Provider Demographics
NPI:1093511784
Name:BARTOLO CARAMES, GONCALO MANUEL (DDS)
Entity type:Individual
Prefix:
First Name:GONCALO
Middle Name:MANUEL
Last Name:BARTOLO CARAMES
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 1:1081 SIERRA DR
Mailing Address - Street 2:
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-6637
Mailing Address - Country:US
Mailing Address - Phone:310-433-5581
Mailing Address - Fax:
Practice Address - Street 1:1081 SIERRA DR
Practice Address - Street 2:
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-6637
Practice Address - Country:US
Practice Address - Phone:310-433-5581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-22
Last Update Date:2025-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE610073501223P0300X
IL019.0357111223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics