Provider Demographics
NPI:1689710071
Name:CARTER, CHARLES H II (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:H
Last Name:CARTER
Suffix:II
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 DEO DARA DR
Mailing Address - Street 2:SUITE#3
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35226-3391
Mailing Address - Country:US
Mailing Address - Phone:205-978-6902
Mailing Address - Fax:
Practice Address - Street 1:1600 DEO DARA DR
Practice Address - Street 2:SUITE#3
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35226-3391
Practice Address - Country:US
Practice Address - Phone:205-978-6902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL44951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice