Provider Demographics
NPI:1730196684
Name:CARTER, STEPHEN WAYNE (DDS)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:WAYNE
Last Name:CARTER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:545 E 4500 S
Mailing Address - Street 2:SUITE E-200
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-2966
Mailing Address - Country:US
Mailing Address - Phone:801-261-2273
Mailing Address - Fax:801-288-2728
Practice Address - Street 1:545 E 4500 S
Practice Address - Street 2:SUITE E-200
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84107-2966
Practice Address - Country:US
Practice Address - Phone:801-261-2273
Practice Address - Fax:801-288-2728
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT139533-99211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice