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General NPI Number Information
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NPI Number | 1821499542
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Entity Type | Organization
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Legal Business Name | KISHA CARTER DMD PC
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Dates
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Enumeration Date | 09/12/2014
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Last Update Date | 02/05/2025
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Provider Practice Location Address
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Address Line | 1203 CLEVELAND AVE STE 1A
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City | EAST POINT
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State | GA
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Zip | 30344-3417
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Country | US
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Telephone | 404-595-5104
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Fax | 404-601-7777
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Provider Business Mailing Address
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Address Line | 1203 CLEVELAND AVE STE 1A
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City | EAST POINT
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State | GA
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Zip | 30344-3417
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Country | US
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Telephone | 404-595-5104
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Fax | 404-601-7777
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Authorized Official
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Title or Position | OWNER
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Name | DR. KISHA CARTER
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Credential | D.M.D.
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Telephone | 404-595-5104
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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 | DN013722
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License Number State | GA
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