Provider Demographics
NPI:1235351883
Name:CART, JOHN BRISTOW (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:BRISTOW
Last Name:CART
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 SUMMER ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14222-2206
Mailing Address - Country:US
Mailing Address - Phone:716-884-5909
Mailing Address - Fax:716-882-8445
Practice Address - Street 1:172 SUMMER ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14222-2206
Practice Address - Country:US
Practice Address - Phone:716-884-5909
Practice Address - Fax:716-882-8445
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0336081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice