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Individual

JADE ANNIQUE CARTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5611 SHELDON RD, TAMPA, FL 33615-3532
(813) 397-5300
(813) 405-3709
Mailing address
PO BOX 82969, TAMPA, FL 33682-2969
(813) 866-0930
(813) 405-3722

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
055835
NY
122300000X
Dentist
Primary
DN22253
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
018536400
FL
Enumeration date
08/02/2010
Last updated
03/21/2023
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