Provider Demographics
NPI:1831292390
Name:J. CARTER WARD DDS PA
Entity Type:Organization
Organization Name:J. CARTER WARD DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CARTER
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:910-799-9059
Mailing Address - Street 1:4914 RANDALL PARKWAY
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403
Mailing Address - Country:US
Mailing Address - Phone:910-799-9059
Mailing Address - Fax:910-799-8274
Practice Address - Street 1:4914 RANDALL PARKWAY
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403
Practice Address - Country:US
Practice Address - Phone:910-799-9059
Practice Address - Fax:910-799-8274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8902KJMedicaid