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General NPI Number Information
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NPI Number | 1891842977
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Entity Type | Individual
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Provider Name | DR. CHRISTOPHER GARRISON
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Gender | Male
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 04/27/2017
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Provider Practice Location Address
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Address Line | 2730 WILSHIRE BLVD STE 201
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City | SANTA MONICA
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State | CA
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Zip | 90403-4743
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Country | US
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Telephone | 424-744-0643
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Fax |
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Provider Business Mailing Address
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Address Line | 848 18TH ST APT 2
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City | SANTA MONICA
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State | CA
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Zip | 90403-1939
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Country | US
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Telephone | 269-414-9045
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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 | 016392
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License Number State | MI
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