Provider Demographics
NPI:1336485960
Name:JOSHUA D CARTER DDS PLLC
Entity Type:Organization
Organization Name:JOSHUA D CARTER DDS PLLC
Other - Org Name:NORTHGATE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:D
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:719-488-2292
Mailing Address - Street 1:1016 MIDDLE CREEK PARKWAY
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80921-3754
Mailing Address - Country:US
Mailing Address - Phone:719-488-2292
Mailing Address - Fax:
Practice Address - Street 1:1016 MIDDLE CREEK PARKWAY
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80921-3754
Practice Address - Country:US
Practice Address - Phone:719-488-2292
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-31
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10358122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty