Healthcare Provider Details

I. General information

NPI: 1376648675
Provider Name (Legal Business Name): ARKLE AND HARRIS ORTHODONTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3010 BAUCOM RD SUITE 100
CHARLOTTE NC
28269-0983
US

IV. Provider business mailing address

3010 BAUCOM RD SUITE 100
CHARLOTTE NC
28269-0983
US

V. Phone/Fax

Practice location:
  • Phone: 704-597-5555
  • Fax:
Mailing address:
  • Phone: 704-597-5555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number7283
License Number StateNC

VIII. Authorized Official

Name: DR. CHRISTOPHER TRAVIS HARRIS
Title or Position: PARTNER
Credential: D.D.S., M.S.
Phone: 704-597-5555