MEDICARE: DR. CHRISTOPHER J CANTRELL 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	1223G0001X	General Practice Dentistry	53196	CA

General Provider Information

NPI Number	:	1730287038
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER J CANTRELL D.M.D.

Provider Business Mailing Address
First Line	:	3001 P ST # A
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95816-6523
Country	:	US
Telephone Number	:	916-736-6750
Fax Number	:	916-736-6755

Provider Business Practice Location Address
First Line	:	3001 P ST # A
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95816-6523
Country	:	US
Telephone Number	:	916-736-6750
Fax Number	:	916-736-6755

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

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	07/08/2007

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