Provider Demographics
NPI:1407831647
Name:CARPENTER, ERIN LEE WATTS (DDS)
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:LEE WATTS
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25521 EAST SMOKY HILL RD.
Mailing Address - Street 2:SUITE 210
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016
Mailing Address - Country:US
Mailing Address - Phone:303-617-5437
Mailing Address - Fax:303-617-4500
Practice Address - Street 1:25521 EAST SMOKY HILL RD.
Practice Address - Street 2:SUITE 210
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016
Practice Address - Country:US
Practice Address - Phone:303-617-5437
Practice Address - Fax:303-617-4500
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-09
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO84661223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO13874764Medicaid