Healthcare Provider Details

I. General information

NPI: 1982981908
Provider Name (Legal Business Name): CHRISTOPHER M HAWKINS DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2011
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 GRAVOIS BLUFFS CIR STE D
FENTON MO
63026-7725
US

IV. Provider business mailing address

170 GRAVOIS BLUFFS CIR STE D
FENTON MO
63026-7725
US

V. Phone/Fax

Practice location:
  • Phone: 636-349-3434
  • Fax: 636-388-0691
Mailing address:
  • Phone: 636-349-3434
  • Fax: 636-388-0691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2010016283
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: