Provider Demographics
NPI:1811244031
Name:CARTER, CHRISTOPHER TALBOT (DMD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:TALBOT
Last Name:CARTER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 MEDICAL PARK
Mailing Address - Street 2:DENTAL DEPT -
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203
Mailing Address - Country:US
Mailing Address - Phone:803-434-6567
Mailing Address - Fax:803-434-6299
Practice Address - Street 1:10 MEDICAL PARK
Practice Address - Street 2:DENTAL DEPT -
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203
Practice Address - Country:US
Practice Address - Phone:803-434-6567
Practice Address - Fax:803-434-6299
Is Sole Proprietor?:No
Enumeration Date:2012-08-07
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC81111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice