Provider Demographics
NPI:1174606321
Name:ALFARO, CARLOS ROBERTO (DDS)
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:ROBERTO
Last Name:ALFARO
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 1:1729 BOCA CHICA BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:BROWNVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520
Mailing Address - Country:US
Mailing Address - Phone:956-544-1321
Mailing Address - Fax:956-544-4123
Practice Address - Street 1:1729 BOCA CHICA BOULEVARD
Practice Address - Street 2:
Practice Address - City:BROWNVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520
Practice Address - Country:US
Practice Address - Phone:956-544-1321
Practice Address - Fax:956-544-4123
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX168081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice