Healthcare Provider Details
I. General information
NPI: 1326278367
Provider Name (Legal Business Name): ERIN WATTS CARPENTER DDS PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/24/2009
Last Update Date: 07/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
25521 EAST SMOKY HILL ROAD SUITE 210
AURORA CO
80016
US
IV. Provider business mailing address
25521 EAST SMOKY HILL ROAD SUITE 210
AURORA CO
80016
US
V. Phone/Fax
- Phone: 303-617-5437
- Fax: 303-617-4500
- Phone: 303-617-5437
- Fax: 303-617-4500
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QD0000X |
| Taxonomy | Dental Clinic/Center |
| License Number | 8466 |
| License Number State | CO |
VIII. Authorized Official
Name: DR.
ERIN
WATTS
CARPENTER
Title or Position: DENTIST/OWNER
Credential: DDS
Phone: 303-617-5437