Provider Demographics
NPI:1912909631
Name:CARNER, AARON BENTLY (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:BENTLY
Last Name:CARNER
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 VENTURE COURT
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29649-1940
Mailing Address - Country:US
Mailing Address - Phone:864-223-0543
Mailing Address - Fax:864-223-3241
Practice Address - Street 1:110 VENTURE COURT
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29649
Practice Address - Country:US
Practice Address - Phone:864-223-0543
Practice Address - Fax:864-223-3241
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4089122300000X
KY7598122300000X
GA126801223P0300X
TN83551223P0300X
VA04014110181223P0300X
SC6121223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223P0300XDental ProvidersDentistPeriodontics