Individual
DR. STACEY RITTER CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
1635 EAST PASS ROAD, GULFPORT, MS 39507
(228) 896-5197
(228) 896-5192
Mailing address
1635 EAST PASS ROAD, GULFPORT, MS 39507
(228) 896-5197
(228) 896-5192
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
3543-10
MS
1223P0221X
Pediatric Dentistry
Primary
3543-10
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05579706
—
MS
Enumeration date
07/22/2010
Last updated
07/24/2012
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