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General NPI Number Information
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NPI Number | 1073956454
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Entity Type | Individual
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Provider Name | CHRISTOPHER MICHAEL ALDRICH DDS
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Gender | Male
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Dates
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Enumeration Date | 04/16/2013
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Last Update Date | 04/16/2013
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Provider Practice Location Address
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Address Line | 2102 KIMBALL AVE
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City | WATERLOO
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State | IA
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Zip | 50702-5037
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Country | US
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Telephone | 319-233-3506
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Fax |
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Provider Business Mailing Address
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Address Line | 1902 HAWKS RIDGE DR APT 116
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City | VERONA
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State | WI
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Zip | 53593-9199
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Country | US
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Telephone | 319-440-0177
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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 | 08933
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License Number State | IA
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