Healthcare Provider Details

I. General information

NPI: 1720043516
Provider Name (Legal Business Name): DOMINIQUE A CARPENTIER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 10/01/2020
Certification Date: 10/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 NEWMARKET RD
DURHAM NH
03824-2826
US

IV. Provider business mailing address

7 HOLLAND WAY FL 1
EXETER NH
03833-2997
US

V. Phone/Fax

Practice location:
  • Phone: 603-868-5832
  • Fax: 603-868-5408
Mailing address:
  • Phone: 603-868-5832
  • Fax: 603-868-5408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number16505
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: