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General NPI Number Information
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NPI Number | 1861998353
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Entity Type | Organization
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Legal Business Name | JOHN L CARTER III DDS
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Dates
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Enumeration Date | 04/03/2018
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 555 W WACKERLY ST STE 3900
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City | MIDLAND
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State | MI
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Zip | 48640-4714
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Country | US
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Telephone | 989-631-8040
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Fax |
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Provider Business Mailing Address
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Address Line | 555 W WACKERLY ST STE 3900
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City | MIDLAND
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State | MI
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Zip | 48640-4714
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Country | US
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Telephone | 989-631-8040
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. SILVIA CARTER
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Credential |
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Telephone | 989-631-8040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 011016
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License Number State | MI
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