Provider Demographics
NPI:1427736248
Name:CHARPENTIER, EMMA DENISE (RDH)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:DENISE
Last Name:CHARPENTIER
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 EMERALD ST
Mailing Address - Street 2:
Mailing Address - City:WELLS
Mailing Address - State:ME
Mailing Address - Zip Code:04090-6165
Mailing Address - Country:US
Mailing Address - Phone:207-216-0888
Mailing Address - Fax:
Practice Address - Street 1:15 OAK ST
Practice Address - Street 2:
Practice Address - City:SPRINGVALE
Practice Address - State:ME
Practice Address - Zip Code:04083-1926
Practice Address - Country:US
Practice Address - Phone:207-490-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-11
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERDH4389124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist