MEDICARE: EDWARD M CARTER D.M.D.

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	1223G0001X	General Practice Dentistry	DS025860L	PA

General Provider Information

NPI Number	:	1538233820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDWARD M CARTER D.M.D.

Provider Business Mailing Address
First Line	:	PO BOX 56
Second Line	:
City	:	TOPTON
State	:	PA
Zip	:	19562-0056
Country	:	US
Telephone Number	:	610-682-2194
Fax Number	:	610-682-2195

Provider Business Practice Location Address
First Line	:	410 W STATE ST
Second Line	:
City	:	MERTZTOWN
State	:	PA
Zip	:	19539-9600
Country	:	US
Telephone Number	:	610-682-2194
Fax Number	:	610-682-2195

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

Provider Enumeration Date	:	11/20/2006
Last Update Date	:	07/08/2007

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