Provider Demographics
NPI:1003919358
Name:CHRISTENSEN, KURT D (DDS)
Entity Type:Individual
Prefix:DR
First Name:KURT
Middle Name:D
Last Name:CHRISTENSEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:7948 S ASHLEY DOWNS CT
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD HEIGHTS
Mailing Address - State:UT
Mailing Address - Zip Code:84093
Mailing Address - Country:US
Mailing Address - Phone:801-268-1135
Mailing Address - Fax:801-685-7630
Practice Address - Street 1:678 E VINE ST
Practice Address - Street 2:12
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-5546
Practice Address - Country:US
Practice Address - Phone:801-268-1135
Practice Address - Fax:801-685-7630
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT3760981223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT00809488OtherUNITED CONCORDIA