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General NPI Number Information
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NPI Number | 1437591120
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Entity Type | Organization
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Legal Business Name | CARTER ORTHODONTICS
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Dates
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Enumeration Date | 07/23/2013
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Last Update Date | 07/23/2013
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Provider Practice Location Address
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Address Line | 456 FURY'S FERRY RD.
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City | AUGUSTA
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State | GA
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Zip | 30907
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Country | US
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Telephone | 706-650-0468
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Fax | 706-650-0568
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Provider Business Mailing Address
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Address Line | 456 FURY'S FERRY RD.
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City | AUGUSTA
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State | GA
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Zip | 30907
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Country | US
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Telephone | 706-650-0468
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Fax | 706-650-0568
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Authorized Official
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Title or Position | OWNER/ORTHODONTIST
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Name | DR. DAVID BRIAN CARTER
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Credential | DMD
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Telephone | 706-650-0468
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 10664
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License Number State | GA
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