Provider Demographics
NPI:1669532057
Name:CARPENTER, TRENA BRITVEN (DDS)
Entity type:Individual
Prefix:DR
First Name:TRENA
Middle Name:BRITVEN
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4924 N LOUIS RIVER WAY
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-4754
Mailing Address - Country:US
Mailing Address - Phone:520-293-7937
Mailing Address - Fax:520-795-4008
Practice Address - Street 1:5190 E FARNESS DR STE 100
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2142
Practice Address - Country:US
Practice Address - Phone:520-795-3773
Practice Address - Fax:520-795-4008
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD61791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice