Provider Demographics
NPI:1043399678
Name:CARPENTER, GARY E SR (DMD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:E
Last Name:CARPENTER
Suffix:SR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 E 10TH AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401
Mailing Address - Country:US
Mailing Address - Phone:541-344-3333
Mailing Address - Fax:541-683-3999
Practice Address - Street 1:401 E 10TH AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401
Practice Address - Country:US
Practice Address - Phone:541-344-3333
Practice Address - Fax:541-683-3999
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5640122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist