Individual
RYAN CARPENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
15480 SE 82ND DR, CLACKAMAS, OR 97015-9633
(503) 655-7250
Mailing address
PO BOX 446, CLACKAMAS, OR 97015-0446
(503) 655-7250
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D8618
OR
Other
Enumeration date
10/09/2014
Last updated
10/09/2014
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