MEDICARE: DR. DAVID CARTER DMD

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	8714	CT
2	1223E0200X	Endodontics	D 7911	AZ
3	1223E0200X	Endodontics	023603	OH

General Provider Information

NPI Number	:	1659582757
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID CARTER DMD

Provider Business Mailing Address
First Line	:	4352 W SYLVANIA AVE
Second Line	:	SUITE D
City	:	TOLEDO
State	:	OH
Zip	:	43623-3463
Country	:	US
Telephone Number	:	419-885-4691
Fax Number	:

Provider Business Practice Location Address
First Line	:	4352 W SYLVANIA AVE
Second Line	:	SUITE D
City	:	TOLEDO
State	:	OH
Zip	:	43623-3463
Country	:	US
Telephone Number	:	419-885-4691
Fax Number	:

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

Provider Enumeration Date	:	05/24/2007
Last Update Date	:	03/03/2012

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