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General NPI Number Information
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NPI Number | 1740408368
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Entity Type | Organization
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Legal Business Name | THE ORTHODONTIC CENTER
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Dates
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Enumeration Date | 04/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9600 TWO NOTCH RD SUITE 22
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City | COLUMBIA
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State | SC
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Zip | 29223-4304
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Country | US
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Telephone | 803-736-1330
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Fax | 803-736-1361
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Provider Business Mailing Address
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Address Line | 9600 TWO NOTCH RD SUITE 22
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City | COLUMBIA
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State | SC
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Zip | 29223-4304
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Country | US
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Telephone | 803-736-1330
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Fax | 803-736-1361
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Authorized Official
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Title or Position | OWNER
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Name | CURTISS W DAUGHTRY
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Credential | DDS
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Telephone | 803-736-1330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | SC1315
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License Number State | SC
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