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General NPI Number Information
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NPI Number | 1952462319
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Entity Type | Organization
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Legal Business Name | DAN W CHARPENTIER DDS PC
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 07/15/2008
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Provider Practice Location Address
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Address Line | 14377 WOODLAKE DR SUITE 210
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City | CHESTERFIELD
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State | MO
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Zip | 63017
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Country | US
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Telephone | 314-878-1114
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Fax | 314-878-8681
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Provider Business Mailing Address
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Address Line | 14377 WOODLAKE DR SUITE 210
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City | CHESTERFIELD
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State | MO
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Zip | 63017
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Country | US
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Telephone | 314-878-1114
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Fax | 314-878-8681
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DAN W CHARPENTIER
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Credential | DDS
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Telephone | 314-878-1114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 014668
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License Number State | MO
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