Provider Demographics
NPI:1447364666
Name:CARTER, DEWEY G (DDS)
Entity type:Individual
Prefix:DR
First Name:DEWEY
Middle Name:G
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 1:853 HEATHER RD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-6288
Mailing Address - Country:US
Mailing Address - Phone:336-228-7749
Mailing Address - Fax:336-570-3315
Practice Address - Street 1:853 HEATHER RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-6288
Practice Address - Country:US
Practice Address - Phone:336-228-7749
Practice Address - Fax:336-570-3315
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC3265204E00000X
VA0401008299204E00000X
FLDN6002204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC91414OtherBCBS
NC8991414Medicaid
NC241040Medicare PIN
NC91414OtherBCBS