Provider Demographics
NPI:1245333434
Name:CARTER, BRUCE H (DDS)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:H
Last Name:CARTER
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 1:332 DUTTON AVE
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-2806
Mailing Address - Country:US
Mailing Address - Phone:510-568-3322
Mailing Address - Fax:510-568-7308
Practice Address - Street 1:332 DUTTON AVE
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-2806
Practice Address - Country:US
Practice Address - Phone:510-568-3322
Practice Address - Fax:510-568-7308
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA166811223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics