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General NPI Number Information
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NPI Number | 1043704075
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Entity Type | Individual
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Provider Name | CHRISTOPHER PROBST DMD
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Gender | Male
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Dates
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Enumeration Date | 06/22/2018
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Last Update Date | 06/29/2020
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Provider Practice Location Address
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Address Line | 5575 WARREN PKWY STE 324
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City | FRISCO
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State | TX
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Zip | 75034-4095
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Country | US
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Telephone | 469-633-0550
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Fax |
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Provider Business Mailing Address
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Address Line | 4669 REUNION DR
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City | PLANO
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State | TX
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Zip | 75024-3841
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Country | US
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Telephone | 262-339-8450
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 019.031693
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 35817
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License Number State | TX
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