MEDICARE: DEWEY G CARTER DDS,PA

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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	3265	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922271840
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEWEY G CARTER DDS,PA

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	:	SECRETARY
Name	:	MRS. MICHELLE LYNN SMITH
Credential	:
Telephone Number	:	336-228-7749

Provider Enumeration Date	:	04/11/2008
Last Update Date	:	04/11/2008

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