MEDICARE: DR. CHRISTOPHER A. EMDIN D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	31102	TX

General Provider Information

NPI Number	:	1164807061
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER A. EMDIN D.D.S.

Provider Business Mailing Address
First Line	:	5310 WOOD CREEK LN
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75044-4916
Country	:	US
Telephone Number	:	972-697-5764
Fax Number	:

Provider Business Practice Location Address
First Line	:	1901 W IRVING BLVD
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75061-6823
Country	:	US
Telephone Number	:	972-870-5800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2015
Last Update Date	:	07/21/2015

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