MEDICARE: DR. DEWEY G CARTER DDS

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	204E00000X	Oral & Maxillofacial Surgery (D.M.D.)	NC3265	NC
2	204E00000X	Oral & Maxillofacial Surgery (D.M.D.)	0401008299	VA
3	204E00000X	Oral & Maxillofacial Surgery (D.M.D.)	DN6002	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	91414	OTHER	NC	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447364666
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEWEY G CARTER DDS

Provider Business Mailing Address
First Line	:	853 HEATHER RD
Second Line	:
City	:	BURLINGTON
State	:	NC
Zip	:	27215-6288
Country	:	US
Telephone Number	:	336-228-7749
Fax Number	:	336-570-3315

Provider Business Practice Location Address
First Line	:	853 HEATHER RD
Second Line	:
City	:	BURLINGTON
State	:	NC
Zip	:	27215-6288
Country	:	US
Telephone Number	:	336-228-7749
Fax Number	:	336-570-3315

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

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	11/01/2007

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