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General NPI Number Information
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NPI Number | 1659377711
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Entity Type | Individual
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Provider Name | WILLIAM CARTER JR. D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 06/23/2005
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Last Update Date | 06/02/2008
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Provider Practice Location Address
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Address Line | 1412 N SHERIDAN ST SUITE B
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City | LAWTON
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State | OK
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Zip | 73505
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Country | US
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Telephone | 580-357-4943
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Fax | 580-357-2072
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Provider Business Mailing Address
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Address Line | 3009 NE MUSE CIR
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City | LAWTON
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State | OK
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Zip | 73507-1926
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Country | US
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Telephone | 580-355-6727
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 731192161
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License Number State | OK
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