Provider Demographics
NPI:1922271840
Name:DEWEY G CARTER DDS,PA
Entity Type:Organization
Organization Name:DEWEY G CARTER DDS,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-228-7749
Mailing Address - Street 1:853 HEATHER RD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-6288
Mailing Address - Country:US
Mailing Address - Phone:336-228-7749
Mailing Address - Fax:336-570-3315
Practice Address - Street 1:853 HEATHER RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-6288
Practice Address - Country:US
Practice Address - Phone:336-228-7749
Practice Address - Fax:336-570-3315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-11
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC32651223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8991414Medicaid
NC8991414Medicaid
NC241040Medicare PIN