Provider Demographics
NPI:1568555969
Name:CARTER & HOFF DENTISTRY
Entity Type:Organization
Organization Name:CARTER & HOFF DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DDS
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:JONES
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:910-395-1585
Mailing Address - Street 1:4316 HENSON DRIVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28405-7424
Mailing Address - Country:US
Mailing Address - Phone:910-395-1585
Mailing Address - Fax:910-392-5249
Practice Address - Street 1:4316 HENSON DRIVE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28405-7424
Practice Address - Country:US
Practice Address - Phone:910-395-1585
Practice Address - Fax:910-392-5249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-30
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5527122300000X
NC7294122300000X
NC7989122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8997604Medicaid
97604OtherBCBS
182423OtherUNITED CONCORDIA
NC8997604Medicaid