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NPI Code Detail

MEDICARE: RICHARD L. CARPENTER, DDS, PLLC

MEDICARE: RICHARD L. CARPENTER, DDS, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry11275MI

General Provider Information

NPI Number : 1184096521
Entity Type Code : Organization
Provider Name (Legal Business Name) : RICHARD L. CARPENTER, DDS, PLLC
Provider Business Mailing Address
First Line : 2532 SPRING ARBOR RD
Second Line : UNIT 4
City : JACKSON
State : MI
Zip : 49203-3663
Country : US
Telephone Number : 517-789-8622
Fax Number : 517-789-8636
Provider Business Practice Location Address
First Line : 2532 SPRING ARBOR RD
Second Line : UNIT 4
City : JACKSON
State : MI
Zip : 49203-3663
Country : US
Telephone Number : 517-789-8622
Fax Number : 517-789-8636
Authorized Official
Title or Position : SOLE MEMBER
Name : DR. RICHARD L CARPENTER
Credential : DDS
Telephone Number : 517-789-8622
Provider Enumeration Date : 10/26/2015
Last Update Date : 10/26/2015

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Directions to “RICHARD L. CARPENTER, DDS, PLLC ” Practice Location

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