Provider Demographics
NPI:1568561850
Name:CARTER, JOHN WOODSON (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:WOODSON
Last Name:CARTER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1666
Mailing Address - Street 2:1085 NORTH ELLINGTON PKWY
Mailing Address - City:LEWISBURG
Mailing Address - State:TN
Mailing Address - Zip Code:37091
Mailing Address - Country:US
Mailing Address - Phone:931-359-2466
Mailing Address - Fax:
Practice Address - Street 1:1085 N ELLINGTON PKWY
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:TN
Practice Address - Zip Code:37091
Practice Address - Country:US
Practice Address - Phone:931-359-2466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS1829122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist