Provider Demographics
NPI:1205495074
Name:HART, CHRISTIAN KEITH (DDS)
Entity type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:KEITH
Last Name:HART
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 BEATTY DR STE 206
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28012-2716
Mailing Address - Country:US
Mailing Address - Phone:704-461-0031
Mailing Address - Fax:704-461-0036
Practice Address - Street 1:210 BEATTY DR STE 206
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012-2716
Practice Address - Country:US
Practice Address - Phone:704-461-0031
Practice Address - Fax:704-461-0036
Is Sole Proprietor?:No
Enumeration Date:2019-06-06
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC113951223G0001X
VA04014165181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice