Healthcare Provider Details
I. General information
NPI: 1013109743
Provider Name (Legal Business Name): CHRISTOPHER MICHAEL SECHRIST DDS, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/16/2007
Last Update Date: 01/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5 E CITRUS AVE SUITE 201
REDLANDS CA
92373-4747
US
IV. Provider business mailing address
700 E REDLANDS BLVD SUITE U-210
REDLANDS CA
92373-6109
US
V. Phone/Fax
- Phone: 909-435-4995
- Fax:
- Phone: 858-876-8743
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223E0200X |
| Taxonomy | Endodontics |
| License Number | 47317 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: