Provider Demographics
NPI:1861577215
Name:CARPENTER, JAMES TERRY (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:TERRY
Last Name:CARPENTER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7905
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79708-7905
Mailing Address - Country:US
Mailing Address - Phone:432-699-7334
Mailing Address - Fax:432-699-7336
Practice Address - Street 1:3300 HAYNES AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79707-3600
Practice Address - Country:US
Practice Address - Phone:432-699-7334
Practice Address - Fax:432-699-7336
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice