Provider Demographics
NPI:1932265899
Name:TREPANIER, CAROL ANN (DDS)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:ANN
Last Name:TREPANIER
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 1:854 ST. MARY'S BLVD
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:ON
Mailing Address - Zip Code:N8S2T9
Mailing Address - Country:CA
Mailing Address - Phone:519-816-2999
Mailing Address - Fax:
Practice Address - Street 1:15510 LIVERNOIS AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48238-1343
Practice Address - Country:US
Practice Address - Phone:313-863-2800
Practice Address - Fax:313-863-5054
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901016776122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist