Healthcare Provider Details

I. General information

NPI: 1487715876
Provider Name (Legal Business Name): CHRISTINE HELEN BISCAN RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 06/09/2022
Certification Date: 06/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8472 SIMONDS ST.
FORT GEORGE G MEADE MD
20755-5800
US

IV. Provider business mailing address

8472 SIMONDS ST.
FT. MEADE MD
20755-2803
US

V. Phone/Fax

Practice location:
  • Phone: 301-677-6078
  • Fax:
Mailing address:
  • Phone: 330-301-0136
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberDH9747
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: