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Individual

DR. MATTHEW THOMAS CARPENTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
351 W 6TH STREET BLDG 440, USA DENTAC, FT STEWART, GA 31314
(912) 767-6735
(912) 767-5425
Mailing address
351 W 6TH STREET BLDG 440, USA DENTAC, FT STEWART, GA 31314
(912) 767-6735
(912) 767-5425

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
4409
SC
1223E0200X
Endodontics
Primary
4409
SC
1223G0001X
General Practice Dentistry
4409
SC

Other

Enumeration date
11/13/2007
Last updated
06/21/2013
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