MEDICARE: DR. STEPHEN WAYNE CARTER D.D.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	1223G0001X	General Practice Dentistry	139533-9921	UT

General Provider Information

NPI Number	:	1730196684
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN WAYNE CARTER D.D.S.

Provider Business Mailing Address
First Line	:	545 E 4500 S
Second Line	:	SUITE E-200
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84107-2966
Country	:	US
Telephone Number	:	801-261-2273
Fax Number	:	801-288-2728

Provider Business Practice Location Address
First Line	:	545 E 4500 S
Second Line	:	SUITE E-200
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84107-2966
Country	:	US
Telephone Number	:	801-261-2273
Fax Number	:	801-288-2728

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

Provider Enumeration Date	:	08/02/2006
Last Update Date	:	07/08/2007

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