Provider Demographics
NPI:1740482991
Name:CARTER, LAURIE CHILDS (DDS)
Entity type:Individual
Prefix:DR
First Name:LAURIE
Middle Name:CHILDS
Last Name:CARTER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 N 12TH ST
Mailing Address - Street 2:315 LYONS BLDG.
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23298-5064
Mailing Address - Country:US
Mailing Address - Phone:804-828-1778
Mailing Address - Fax:804-828-6234
Practice Address - Street 1:520 N 12TH ST
Practice Address - Street 2:315 LYONS BLDG.
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-5064
Practice Address - Country:US
Practice Address - Phone:804-828-1778
Practice Address - Fax:804-828-6234
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0411000032122300000X
NY037539-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist