Provider Demographics
NPI:1245348671
Name:HARRIS, CHRISTOPHER TRAVIS (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:TRAVIS
Last Name:HARRIS
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3010 BAUCOM RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-0983
Mailing Address - Country:US
Mailing Address - Phone:704-597-5555
Mailing Address - Fax:
Practice Address - Street 1:3010 BAUCOM RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-0983
Practice Address - Country:US
Practice Address - Phone:704-597-5555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC72831223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics