MEDICARE: DR. PARVIN S CARTER D.D.S., M.A.G.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	8376	IN
2	1223G0001X	General Practice Dentistry	53161	CA

General Provider Information

NPI Number	:	1104821354
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PARVIN S CARTER D.D.S., M.A.G.D.

Provider Business Mailing Address
First Line	:	1667 HILLTOP DR
Second Line	:	STE 13
City	:	REDDING
State	:	CA
Zip	:	96002-0240
Country	:	US
Telephone Number	:	530-917-6628
Fax Number	:	530-917-6628

Provider Business Practice Location Address
First Line	:	4268 BOSTON AVE
Second Line	:
City	:	REDDING
State	:	CA
Zip	:	96001-5814
Country	:	US
Telephone Number	:	530-917-6628
Fax Number	:	530-917-6628

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	03/23/2011

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