Provider Demographics
NPI:1689722811
Name:GARY A CARTER, D.D.S., M.S., PC
Entity Type:Organization
Organization Name:GARY A CARTER, D.D.S., M.S., PC
Other - Org Name:ORTHODONTIC SPECIALISTS OF UTAH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:801-255-9000
Mailing Address - Street 1:12207 WIGWAM LN
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-8855
Mailing Address - Country:US
Mailing Address - Phone:801-495-1876
Mailing Address - Fax:
Practice Address - Street 1:45 W SEGO LILY DR
Practice Address - Street 2:#106
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84070-3299
Practice Address - Country:US
Practice Address - Phone:801-255-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT335041-9921261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental