MEDICARE: DR. CHRISTIAN ACHLEITHNER D.M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223E0200X	Endodontics	D6385	OR

General Provider Information

NPI Number	:	1437482304
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTIAN ACHLEITHNER D.M.D

Provider Business Mailing Address
First Line	:	5230 S 6TH ST
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97603-5002
Country	:	US
Telephone Number	:	541-273-1560
Fax Number	:	541-850-0637

Provider Business Practice Location Address
First Line	:	5230 S 6TH ST
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97603-5002
Country	:	US
Telephone Number	:	541-273-1560
Fax Number	:	541-850-0637

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/10/2009
Last Update Date	:	09/10/2009

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