Provider Demographics
NPI:1356342455
Name:J. MARC CARPENTER DDS, P.C.
Entity type:Organization
Organization Name:J. MARC CARPENTER DDS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:MR
Authorized Official - First Name:J. MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:CARPENTER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-427-4120
Mailing Address - Street 1:8774 YATES DR
Mailing Address - Street 2:#340
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-6958
Mailing Address - Country:US
Mailing Address - Phone:303-427-4120
Mailing Address - Fax:303-427-4009
Practice Address - Street 1:8774 YATES DR
Practice Address - Street 2:#340
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-6958
Practice Address - Country:US
Practice Address - Phone:303-427-4120
Practice Address - Fax:303-427-4009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1043081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty