Individual
BRANDON CARTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
186 CLINTON ST, HEMPSTEAD, NY 11550-2600
(516) 483-8136
Mailing address
45 W 132ND ST, APT 2M, NEW YORK, NY 10037-3101
(919) 368-5490
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
058310
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04348610
—
NY
Enumeration date
11/26/2014
Last updated
05/12/2016
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