Provider Demographics
NPI:1356466122
Name:CHARLES J CARTER DDS PC
Entity Type:Organization
Organization Name:CHARLES J CARTER DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:J
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:706-549-1370
Mailing Address - Street 1:855 SUNSET DR
Mailing Address - Street 2:SUITE 10
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-7718
Mailing Address - Country:US
Mailing Address - Phone:706-549-1370
Mailing Address - Fax:706-549-7668
Practice Address - Street 1:855 SUNSET DR
Practice Address - Street 2:SUITE 10
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-7718
Practice Address - Country:US
Practice Address - Phone:706-549-1370
Practice Address - Fax:706-549-7668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental