Organization
CARTER DENTAL, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. W JASON CARTER DDS (OWNER/DENTIST)
(208) 376-6346
Entity
Organization
Contact information
Practice address
7878 USTICK RD STE 102, BOISE, ID 83704-5006
(208) 376-6346
(208) 246-0508
Mailing address
7878 USTICK RD STE 102, BOISE, ID 83704-5006
(208) 376-6346
(208) 246-0508
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
D1401
ID
1223G0001X
General Practice Dentistry
Primary
D3384
ID
1223G0001X
General Practice Dentistry
D3693
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
434421
UNITED CONCORDIA
PA
01
—
6I047
BLUE CROSS OF IDAHO
ID
Enumeration date
05/15/2008
Last updated
05/15/2008
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