| NPI | 1851467815 |
|---|---|
| Other Name | MIKE CARPENTER |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CO 9586) |
| Additional Taxonomies | 122300000X Dentist (Licence: AZ AZ5407) |
| 1223G0001X Dentist, General Practice (Licence: CO 9586) | |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2023-07-15 |