Individual
MYRISSA CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
807 E MAIN ST, MIDDLETOWN, MD 21769-7722
(301) 293-6828
Mailing address
807 E MAIN ST, MIDDLETOWN, MD 21769-7722
(301) 293-6828
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
16808
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/26/2019
Last updated
06/11/2020
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