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General NPI Number Information
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NPI Number | 1043254832
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Entity Type | Organization
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Legal Business Name | WM R CHRISTIAN DDS SC
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 06/24/2008
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Provider Practice Location Address
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Address Line | 820 TWO MILE AVE
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City | WISCONSIN RAPIDS
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State | WI
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Zip | 54494
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Country | US
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Telephone | 715-421-2330
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Fax | 715-421-3425
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Provider Business Mailing Address
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Address Line | 820 TWO MILE AVE
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City | WISCONSIN RAPIDS
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State | WI
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Zip | 54494
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Country | US
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Telephone | 715-421-2330
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Fax | 715-421-3425
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Authorized Official
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Title or Position | PRESIDENT OWNER DENTIST
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Name | DR. WILLIAM R CHRISTIAN
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Credential | DOCTOR OF DENTISTRY
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Telephone | 715-421-2330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0614G
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License Number State | WI
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