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General NPI Number Information
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NPI Number | 1114595683
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Entity Type | Individual
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Provider Name | CHRISTOPHER FLOOD DDS
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Gender | Male
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Dates
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Enumeration Date | 06/11/2021
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Last Update Date | 06/28/2021
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Provider Practice Location Address
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Address Line | 1625 W PARADISE DR
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City | WEST BEND
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State | WI
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Zip | 53095-7846
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Country | US
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Telephone | 262-338-2992
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Fax |
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Provider Business Mailing Address
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Address Line | 28 DIANE LN
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City | APPLETON
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State | WI
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Zip | 54915-7204
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Country | US
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Telephone |
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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 | 100256915
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License Number State | WI
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