Provider Demographics
NPI:1437338365
Name:PROGRESSIVE DENTISTRY & ORTHODONTICS
Entity Type:Organization
Organization Name:PROGRESSIVE DENTISTRY & ORTHODONTICS
Other - Org Name:DAVID S. CARTER DDS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EMPLOYEE
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:S
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-775-8600
Mailing Address - Street 1:2995 W ELLIOT RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-1670
Mailing Address - Country:US
Mailing Address - Phone:480-775-8600
Mailing Address - Fax:480-775-0240
Practice Address - Street 1:2995 W ELLIOT RD
Practice Address - Street 2:SUITE 1
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-1670
Practice Address - Country:US
Practice Address - Phone:480-775-8600
Practice Address - Fax:480-775-0240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-28
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty