Healthcare Provider Details

I. General information

NPI: 1811710999
Provider Name (Legal Business Name): ROBERT T. CHRISTENSEN, D.D.S., M.S., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2024
Last Update Date: 11/06/2024
Certification Date: 11/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 W WOODCROFT PKWY
DURHAM NC
27713-9471
US

IV. Provider business mailing address

121 W WOODCROFT PKWY
DURHAM NC
27713-9471
US

V. Phone/Fax

Practice location:
  • Phone: 919-489-1543
  • Fax: 919-489-2892
Mailing address:
  • Phone: 919-489-1543
  • Fax: 919-489-2892

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT THOMAS CHRISTENSEN
Title or Position: OWNER
Credential: DDS
Phone: 919-489-1543