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General NPI Number Information
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NPI Number | 1740530567
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Entity Type | Organization
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Legal Business Name | CHRISTEN MITCHELL DMD LLC
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Dates
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Enumeration Date | 09/19/2012
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Last Update Date | 09/19/2012
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Provider Practice Location Address
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Address Line | 2828 S MCCALL RD SUITE 24
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City | ENGLEWOOD
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State | FL
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Zip | 34224-7791
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Country | US
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Telephone | 941-474-2223
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Fax |
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Provider Business Mailing Address
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Address Line | 2828 S MCCALL RD SUITE 24
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City | ENGLEWOOD
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State | FL
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Zip | 34224-7791
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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 | PRESIDENT
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Name | DR. CHRISTEN MITCHELL
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Credential |
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Telephone | 941-737-6899
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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 | DN16418
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License Number State | FL
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