Provider Demographics
NPI:1346227600
Name:DENTON, CARRIE MARLENE (RDH)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:MARLENE
Last Name:DENTON
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 N AVENIDA DE LA TUCA
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-1419
Mailing Address - Country:US
Mailing Address - Phone:520-228-1545
Mailing Address - Fax:520-228-2834
Practice Address - Street 1:30 N AVENIDA DE LA TUCA
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-1419
Practice Address - Country:US
Practice Address - Phone:520-228-1545
Practice Address - Fax:520-228-2834
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZH4884124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist