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General NPI Number Information
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NPI Number | 1568503753
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Entity Type | Organization
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Legal Business Name | H. FRED CHRISTMAN, D.D.S., L.L.C.
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 03/06/2015
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Provider Practice Location Address
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Address Line | 9 WEST BLVD NORTH
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City | COLUMBIA
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State | MO
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Zip | 65203
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Country | US
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Telephone | 573-449-5466
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Fax | 573-441-2566
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Provider Business Mailing Address
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Address Line | 9 WEST BLVD NORTH
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City | COLUMBIA
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State | MO
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Zip | 65203
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Country | US
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Telephone | 573-449-5466
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Fax | 573-441-2566
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Authorized Official
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Title or Position | MEMBER/MANAGER
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Name | H FRED CHRISTMAN
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Credential | D.D.S.
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Telephone | 573-449-5466
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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 | MO 14100
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License Number State | MO
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