Healthcare Provider Details

I. General information

NPI: 1780020057
Provider Name (Legal Business Name): CHRISTINA M BEHRING D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINA M LAZZARI D.D.S.

II. Dates (important events)

Enumeration Date: 05/14/2013
Last Update Date: 09/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

292 E SAGINAW RD
SANFORD MI
48657-9220
US

IV. Provider business mailing address

292 E SAGINAW RD
SANFORD MI
48657-9220
US

V. Phone/Fax

Practice location:
  • Phone: 989-687-7378
  • Fax:
Mailing address:
  • Phone: 989-687-7378
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2901020900
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: