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General NPI Number Information
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NPI Number | 1861177750
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Entity Type | Individual
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Provider Name | CARTER SEAN MULLINS DDS
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Gender | Male
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Dates
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Enumeration Date | 06/19/2023
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Last Update Date | 06/19/2023
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Provider Practice Location Address
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Address Line | 15325 LEE HWY
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City | BRISTOL
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State | VA
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Zip | 24202-4013
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Country | US
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Telephone | 276-466-9800
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Fax |
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Provider Business Mailing Address
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Address Line | 112 GREINER DR
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City | BRISTOL
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State | TN
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Zip | 37620-2916
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Country | US
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Telephone | 423-797-1866
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 0401418520
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License Number State | VA
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