MEDICARE: DR. WILLIAM MICHAEL 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	122300000X	Dentist	AZ5407	AZ
2	122300000X	Dentist	9586	CO
3	1223G0001X	General Practice Dentistry	9586	CO

General Provider Information

NPI Number	:	1851467815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM MICHAEL CARPENTER DDS

Provider Business Mailing Address
First Line	:	2876 N PINAL AVE STE 4
Second Line	:
City	:	CASA GRANDE
State	:	AZ
Zip	:	85122-7944
Country	:	US
Telephone Number	:	720-635-1922
Fax Number	:

Provider Business Practice Location Address
First Line	:	5068 W 92ND AVE
Second Line	:
City	:	WESTMINSTER
State	:	CO
Zip	:	80031-6302
Country	:	US
Telephone Number	:	720-635-1922
Fax Number	:

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

Provider Enumeration Date	:	11/28/2006
Last Update Date	:	07/15/2023

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