Provider Demographics
NPI:1740408368
Name:THE ORTHODONTIC CENTER
Entity Type:Organization
Organization Name:THE ORTHODONTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CURTISS
Authorized Official - Middle Name:W
Authorized Official - Last Name:DAUGHTRY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:803-736-1330
Mailing Address - Street 1:9600 TWO NOTCH RD
Mailing Address - Street 2:SUITE 22
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-4304
Mailing Address - Country:US
Mailing Address - Phone:803-736-1330
Mailing Address - Fax:803-736-1361
Practice Address - Street 1:9600 TWO NOTCH RD
Practice Address - Street 2:SUITE 22
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-4304
Practice Address - Country:US
Practice Address - Phone:803-736-1330
Practice Address - Fax:803-736-1361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC13151223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty