MEDICARE: CARTER ORTHODONTICS, PC

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	106412	CO

General Provider Information

NPI Number	:	1245389147
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARTER ORTHODONTICS, PC

Provider Business Mailing Address
First Line	:	3333 S WADSWORTH BLVD
Second Line	:	SUITE D-310
City	:	LAKEWOOD
State	:	CO
Zip	:	80227-5122
Country	:	US
Telephone Number	:	303-986-7846
Fax Number	:	303-988-4507

Provider Business Practice Location Address
First Line	:	3333 S WADSWORTH BLVD
Second Line	:	SUITE D-310
City	:	LAKEWOOD
State	:	CO
Zip	:	80227-5122
Country	:	US
Telephone Number	:	303-986-7846
Fax Number	:	303-988-4507

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. STEPHEN L CARTER
Credential	:	DDS, MS
Telephone Number	:	303-986-7846

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	08/22/2020

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