Provider Demographics
NPI:1528436326
Name:MICHELE L CARTER DDS LLC
Entity type:Organization
Organization Name:MICHELE L CARTER DDS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:575-622-3012
Mailing Address - Street 1:2723 CHRYSLER DR
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:NM
Mailing Address - Zip Code:88201-5207
Mailing Address - Country:US
Mailing Address - Phone:575-914-5533
Mailing Address - Fax:575-622-6193
Practice Address - Street 1:711 W ALAMEDA ST
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:NM
Practice Address - Zip Code:88203-4403
Practice Address - Country:US
Practice Address - Phone:575-622-3012
Practice Address - Fax:575-622-6193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-10
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty