Provider Demographics
NPI:1528143955
Name:CHARPENTIER, REBECCA H (DDS)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:H
Last Name:CHARPENTIER
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 1:600 RUE DE ONETTA
Mailing Address - Street 2:
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70563
Mailing Address - Country:US
Mailing Address - Phone:337-981-9811
Mailing Address - Fax:
Practice Address - Street 1:600 RUE DE ONETTA
Practice Address - Street 2:
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70563
Practice Address - Country:US
Practice Address - Phone:337-981-9811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA57111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice