=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760772255
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NORMAN E. CARTER DDS MS INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/18/2011
-----------------------------------------------------
Last Update Date | 04/18/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 851 E 6TH ST B3
-----------------------------------------------------
City | BEAUMONT
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92223-2373
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-769-8885
-----------------------------------------------------
Fax | 951-769-8998
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 851 E 6TH ST STE B3
-----------------------------------------------------
City | BEAUMONT
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92223-2371
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-769-8885
-----------------------------------------------------
Fax | 951-769-8998
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ORTHODONTIST
-----------------------------------------------------
Name | DR. NORMAN ERIC CARTER
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 951-769-8885
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223X0400X
-----------------------------------------------------
Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
-----------------------------------------------------
License Number | 54669
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1223X0400X
-----------------------------------------------------
Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
-----------------------------------------------------
License Number | 59959
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------