Provider Demographics
NPI:1184351884
Name:OSCAR J. CARBONELL DDS A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:OSCAR J. CARBONELL DDS A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:J
Authorized Official - Last Name:CARBONELL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-353-1615
Mailing Address - Street 1:8654 FOOTHILL BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:SUNLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91040-1911
Mailing Address - Country:US
Mailing Address - Phone:818-323-1615
Mailing Address - Fax:
Practice Address - Street 1:8654 FOOTHILL BLVD STE B
Practice Address - Street 2:
Practice Address - City:SUNLAND
Practice Address - State:CA
Practice Address - Zip Code:91040-1911
Practice Address - Country:US
Practice Address - Phone:818-323-1615
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-02
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental