MEDICARE: ANDRE CHRISTENSEN DDS

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	122300000X	Dentist	DN 18952	FL

General Provider Information

NPI Number	:	1598083271
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDRE CHRISTENSEN DDS

Provider Business Mailing Address
First Line	:	25095 KIBLER LN
Second Line	:
City	:	BROOKSVILLE
State	:	FL
Zip	:	34601-7002
Country	:	US
Telephone Number	:	386-232-8489
Fax Number	:

Provider Business Practice Location Address
First Line	:	5080 COMMERCIAL WAY
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34606-1929
Country	:	US
Telephone Number	:	352-596-7388
Fax Number	:

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

Provider Enumeration Date	:	05/05/2010
Last Update Date	:	05/06/2018

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