Provider Demographics
NPI:1033325857
Name:CARTER, MYLES A (DDS DENTIST)
Entity Type:Individual
Prefix:
First Name:MYLES
Middle Name:A
Last Name:CARTER
Suffix:
Gender:M
Credentials:DDS DENTIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 HUNT CT
Mailing Address - Street 2:
Mailing Address - City:GLEN HEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11545-2749
Mailing Address - Country:US
Mailing Address - Phone:516-625-6818
Mailing Address - Fax:631-435-8221
Practice Address - Street 1:19 HUNT CT
Practice Address - Street 2:
Practice Address - City:GLEN HEAD
Practice Address - State:NY
Practice Address - Zip Code:11545-2749
Practice Address - Country:US
Practice Address - Phone:516-625-6818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY03768911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice