Individual
DR. TRAE JORDAN CARPENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1700 W CHARLESTON BLVD, LAS VEGAS, NV 89102-2335
(702) 774-2690
Mailing address
6146 SW 18TH DR APT 61, PORTLAND, OR 97239-7906
(541) 531-4245
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
OR
Other
Enumeration date
04/03/2025
Last updated
04/03/2025
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