MEDICARE: DR. GARY ANTHONY CARTER D.D.S., M.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	335041-9921	UT

General Provider Information

NPI Number	:	1003812116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY ANTHONY CARTER D.D.S., M.S.

Provider Business Mailing Address
First Line	:	12207 S WIGWAM LN
Second Line	:
City	:	DRAPER
State	:	UT
Zip	:	84020-8855
Country	:	US
Telephone Number	:	385-445-1777
Fax Number	:

Provider Business Practice Location Address
First Line	:	4645 S 4000 W STE B
Second Line	:
City	:	WEST VALLEY CITY
State	:	UT
Zip	:	84120-6250
Country	:	US
Telephone Number	:	801-955-1900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	10/11/2024

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