Provider Demographics
NPI:1265520175
Name:CARIN, MANUEL ALBERT (DDS)
Entity type:Individual
Prefix:DR
First Name:MANUEL
Middle Name:ALBERT
Last Name:CARIN
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 1:82 MARIPOSA AVE
Mailing Address - Street 2:STE B
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076-2847
Mailing Address - Country:US
Mailing Address - Phone:831-724-7211
Mailing Address - Fax:831-724-7211
Practice Address - Street 1:82 MARIPOSA
Practice Address - Street 2:STE B
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-2847
Practice Address - Country:US
Practice Address - Phone:831-724-7211
Practice Address - Fax:831-724-7211
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37392122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist