Organization
HICKORY FLAT ORTHODONTICS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARL M. RUSSELL DMD, PHD (PRESIDENT)
(770) 720-8138
Entity
Organization
Contact information
Practice address
6488 HICKORY FLAT HWY, CANTON, GA 30115-7235
(770) 720-8138
(770) 720-7580
Mailing address
6488 HICKORY FLAT HWY, CANTON, GA 30115-7235
(770) 720-8138
(770) 720-7580
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
04/24/2007
Last updated
08/22/2020
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