Provider Demographics
NPI:1114101078
Name:DR. TODD CARTER D.D.S
Entity Type:Organization
Organization Name:DR. TODD CARTER D.D.S
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTAL ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:COXEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-940-2342
Mailing Address - Street 1:123 NC HIGHWAY 801 S. #C-100
Mailing Address - Street 2:
Mailing Address - City:ADVANCE
Mailing Address - State:NC
Mailing Address - Zip Code:27006
Mailing Address - Country:US
Mailing Address - Phone:336-940-2342
Mailing Address - Fax:
Practice Address - Street 1:123 NC HIGHWAY 801 S. #C-100
Practice Address - Street 2:
Practice Address - City:ADVANCE
Practice Address - State:NC
Practice Address - Zip Code:27006
Practice Address - Country:US
Practice Address - Phone:336-940-2342
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-27
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC5973122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty