Provider Demographics
NPI:1275548679
Name:CARTER DENTAL OFFICE, PLLC
Entity Type:Organization
Organization Name:CARTER DENTAL OFFICE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:423-745-1988
Mailing Address - Street 1:PO BOX 607
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:TN
Mailing Address - Zip Code:37371-0607
Mailing Address - Country:US
Mailing Address - Phone:423-745-1988
Mailing Address - Fax:423-745-1515
Practice Address - Street 1:2416 CONGRESS PKWY S
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TN
Practice Address - Zip Code:37303-2822
Practice Address - Country:US
Practice Address - Phone:423-745-1988
Practice Address - Fax:423-745-1515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS0071821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty