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General NPI Number Information
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NPI Number | 1528436326
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Entity Type | Organization
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Legal Business Name | MICHELE L CARTER DDS LLC
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Dates
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Enumeration Date | 09/10/2015
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Last Update Date | 09/10/2015
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Provider Practice Location Address
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Address Line | 711 W ALAMEDA ST
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City | ROSWELL
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State | NM
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Zip | 88203-4403
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Country | US
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Telephone | 575-622-3012
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Fax | 575-622-6193
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Provider Business Mailing Address
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Address Line | 2723 CHRYSLER DR
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City | ROSWELL
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State | NM
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Zip | 88201-5207
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Country | US
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Telephone | 575-914-5533
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Fax | 575-622-6193
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. MICHELE CARTER
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Credential | DDS
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Telephone | 575-622-3012
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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