Provider Demographics
NPI:1104974161
Name:GARY A. CARTER, D.D.S., M.S., PC
Entity type:Organization
Organization Name:GARY A. CARTER, D.D.S., M.S., PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:801-288-9100
Mailing Address - Street 1:6052 S STATE ST
Mailing Address - Street 2:SUITE 7
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-7225
Mailing Address - Country:US
Mailing Address - Phone:801-288-9100
Mailing Address - Fax:
Practice Address - Street 1:6052 S STATE ST
Practice Address - Street 2:SUITE 7
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-7225
Practice Address - Country:US
Practice Address - Phone:801-288-9100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT335041-9921261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental