Healthcare Provider Details

I. General information

NPI: 1285755033
Provider Name (Legal Business Name): CHRISTOPHER CARTER DMD, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 01/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26137 LA PAZ ROAD SUITE 220
MISSION VIEJO CA
92691
US

IV. Provider business mailing address

26137 LA PAZ ROAD SUITE 220
MISSION VIEJO CA
92691
US

V. Phone/Fax

Practice location:
  • Phone: 949-581-5800
  • Fax: 949-581-6794
Mailing address:
  • Phone: 949-581-5800
  • Fax: 949-581-6794

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number49733
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number49733
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: