MEDICARE: MARCY CARPENTER DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry	DEN.00206198	CO

General Provider Information

NPI Number	:	1346898665
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCY CARPENTER DDS

Provider Business Mailing Address
First Line	:	1576 MAIN ST
Second Line	:
City	:	WINDSOR
State	:	CO
Zip	:	80550-7909
Country	:	US
Telephone Number	:	970-674-3247
Fax Number	:

Provider Business Practice Location Address
First Line	:	1576 MAIN ST
Second Line	:
City	:	WINDSOR
State	:	CO
Zip	:	80550-7909
Country	:	US
Telephone Number	:	970-674-3247
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2019
Last Update Date	:	02/17/2025

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Directions to “ MARCY CARPENTER DDS” Practice Location

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