Provider Demographics
NPI:1538252382
Name:CARLIN, GREG P
Entity type:Individual
Prefix:MR
First Name:GREG
Middle Name:P
Last Name:CARLIN
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:PAUL
Other - Middle Name:GREGORY
Other - Last Name:CARLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:800 SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:GRIDLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95948-2127
Mailing Address - Country:US
Mailing Address - Phone:530-846-2426
Mailing Address - Fax:530-846-5019
Practice Address - Street 1:800 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:GRIDLEY
Practice Address - State:CA
Practice Address - Zip Code:95948-2127
Practice Address - Country:US
Practice Address - Phone:530-846-2426
Practice Address - Fax:530-846-5019
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA272491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice