Healthcare Provider Details

I. General information

NPI: 1851440903
Provider Name (Legal Business Name): DENTAL EXCELLENCE OF NAPOLEON, LLC, MICHAEL CARPENTER, D.D.S.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 01/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 WESTMORELAND AVE
NAPOLEON OH
43545-1260
US

IV. Provider business mailing address

875 WESTMORELAND AVE
NAPOLEON OH
43545-1260
US

V. Phone/Fax

Practice location:
  • Phone: 419-592-9956
  • Fax: 419-592-9855
Mailing address:
  • Phone: 419-592-9956
  • Fax: 419-592-9855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number30.020485
License Number StateOH

VIII. Authorized Official

Name: DR. MICHAEL DEAN CARPENTER
Title or Position: OWNER
Credential: DDS
Phone: 419-592-9956