Provider Demographics
NPI:1376763581
Name:CARPENTER, JAMES LEE (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:LEE
Last Name:CARPENTER
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 1:2600 ANN DRIVE
Mailing Address - Street 2:
Mailing Address - City:BIG SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:79720
Mailing Address - Country:US
Mailing Address - Phone:432-263-4916
Mailing Address - Fax:432-263-4916
Practice Address - Street 1:2001 RICKABAUGH DR
Practice Address - Street 2:
Practice Address - City:BIG SPRING
Practice Address - State:TX
Practice Address - Zip Code:79720-7702
Practice Address - Country:US
Practice Address - Phone:432-267-7911
Practice Address - Fax:432-263-6295
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-27
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX135941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice