Provider Demographics
NPI:1073893905
Name:CARTY, MARIA RALUCA (DMD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:RALUCA
Last Name:CARTY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 S CASS ST
Mailing Address - Street 2:
Mailing Address - City:BERRIEN SPRINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49103-1206
Mailing Address - Country:US
Mailing Address - Phone:770-827-3301
Mailing Address - Fax:
Practice Address - Street 1:331 N CHERRY ST
Practice Address - Street 2:
Practice Address - City:VALENTINE
Practice Address - State:NE
Practice Address - Zip Code:69201-1880
Practice Address - Country:US
Practice Address - Phone:402-376-3390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-23
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE69801223G0001X
GADN0142761223G0001X
IN12012044A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice