Provider Demographics
NPI:1205942471
Name:CARTER, ROBERT JUDSON (DDS)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:JUDSON
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 1:719 E AIRPORT AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-6519
Mailing Address - Country:US
Mailing Address - Phone:225-924-3369
Mailing Address - Fax:225-924-3387
Practice Address - Street 1:719 E AIRPORT AVE
Practice Address - Street 2:SUITE A
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-6519
Practice Address - Country:US
Practice Address - Phone:225-924-3369
Practice Address - Fax:225-924-3387
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2798122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist