Provider Demographics
NPI:1073182176
Name:CARPENTER, EMMA LAURA-MCCULLA (DMD)
Entity Type:Individual
Prefix:DR
First Name:EMMA
Middle Name:LAURA-MCCULLA
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:990 DELBON AVE
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95382-2019
Mailing Address - Country:US
Mailing Address - Phone:209-667-7889
Mailing Address - Fax:
Practice Address - Street 1:990 DELBON AVE
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-2019
Practice Address - Country:US
Practice Address - Phone:209-667-7889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-22
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1062231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice