Provider Demographics
NPI:1518031327
Name:CARPENTER, DAVID ROY
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ROY
Last Name:CARPENTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 EAST WENDOVER AVENUE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27455-3207
Mailing Address - Country:US
Mailing Address - Phone:336-272-4583
Mailing Address - Fax:336-378-6986
Practice Address - Street 1:200 EAST WENDOVER AVENUE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27455-3207
Practice Address - Country:US
Practice Address - Phone:336-272-4583
Practice Address - Fax:336-378-6986
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5072122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist