Organization
CLASSIC CITY ORTHODONTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER TRADD HARTER DMD (PRESIDENT)
(706) 549-4748
Entity
Organization
Contact information
Practice address
1020 JAMESTOWN BLVD BLDG 100, WATKINSVILLE, GA 30677-4131
(706) 549-4748
(706) 549-9822
Mailing address
1020 JAMESTOWN BLVD BLDG 100, WATKINSVILLE, GA 30677-4131
(706) 549-4748
(706) 549-9822
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
12/04/2019
Last updated
12/04/2019
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