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General NPI Number Information
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NPI Number | 1093204638
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Entity Type | Organization
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Legal Business Name | PATRICK D. CHRISTENSEN, P.L.L.C.
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Dates
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Enumeration Date | 05/09/2018
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Last Update Date | 05/09/2018
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Provider Practice Location Address
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Address Line | 2120 W GUADALUPE RD STE 5
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City | MESA
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State | AZ
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Zip | 85202-7366
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Country | US
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Telephone | 480-839-0985
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Fax | 480-730-8631
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Provider Business Mailing Address
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Address Line | 2120 W GUADALUPE RD STE 5
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City | MESA
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State | AZ
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Zip | 85202-7366
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Country | US
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Telephone | 480-839-0985
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Fax | 480-730-8631
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Authorized Official
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Title or Position | OWNER
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Name | DR. PATRICK D. CHRISTENSEN
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Credential | D.M.D., M.A.
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Telephone | 480-839-0985
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | D009232
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License Number State | AZ
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