MEDICARE: DR. AUBREY R CARTER JR. 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	4731	WA

General Provider Information

NPI Number	:	1801085030
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AUBREY R CARTER JR. D.D.S.

Provider Business Mailing Address
First Line	:	12919 78TH PL SE
Second Line	:
City	:	SNOHOMISH
State	:	WA
Zip	:	98290-6202
Country	:	US
Telephone Number	:	360-568-3811
Fax Number	:

Provider Business Practice Location Address
First Line	:	19718 68TH AVE W
Second Line	:	SUITE G
City	:	LYNNWOOD
State	:	WA
Zip	:	98036-5965
Country	:	US
Telephone Number	:	425-778-6677
Fax Number	:

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

Provider Enumeration Date	:	10/24/2007
Last Update Date	:	10/24/2007

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