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General NPI Number Information
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NPI Number | 1700856515
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Entity Type | Individual
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Provider Name | TRENTINGTON LANE OUTHOUSE DDS, MS, FAGD, ABGD
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Gender | Male
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Dates
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Enumeration Date | 01/24/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | NBHC, NSA, ASU, BAH PSC 451 BOX 340
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City | FPO
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State | AE
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Zip | 09834-2800
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Country | BH
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Telephone | 01197339607621
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Fax |
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Provider Business Mailing Address
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Address Line | NBHC, NSA, ASU, BAH PSC 451 BOX 340
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City | FPO
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State | AE
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Zip | 09834-2800
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Country | BH
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Telephone | 01197339607621
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 52796
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 4980
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License Number State | LA
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