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General NPI Number Information
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NPI Number | 1184157398
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Entity Type | Organization
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Legal Business Name | CHRISTOPHER W KINDIG, DMD, PA
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Dates
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Enumeration Date | 04/05/2017
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Last Update Date | 04/05/2017
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Provider Practice Location Address
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Address Line | 3380 NE SUGARHILL AVE
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City | JENSEN BEACH
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State | FL
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Zip | 34957-3724
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Country | US
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Telephone | 772-334-3653
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Fax | 772-334-9840
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Provider Business Mailing Address
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Address Line | 3380 NE SUGARHILL AVE
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City | JENSEN BEACH
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State | FL
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Zip | 34957-3724
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Country | US
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Telephone | 772-334-3653
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Fax | 772-334-9840
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTOPHER W KINDIG
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Credential | DMD
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Telephone | 772-334-3653
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 16759
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License Number State | FL
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