Provider Demographics
NPI:1750566303
Name:CARPENTER, JOHN FOSTER (DMD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:FOSTER
Last Name:CARPENTER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:272 QUASSAICK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:12553-7631
Mailing Address - Country:US
Mailing Address - Phone:845-561-2330
Mailing Address - Fax:
Practice Address - Street 1:272 QUASSAICK AVE
Practice Address - Street 2:
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553-7631
Practice Address - Country:US
Practice Address - Phone:845-561-2330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-02
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY36669122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist