Provider Demographics
NPI:1013044650
Name:OWUOR, CHRISTINE ADHIAMBO (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:ADHIAMBO
Last Name:OWUOR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 HICKMAN RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-3554
Mailing Address - Country:US
Mailing Address - Phone:434-973-2520
Mailing Address - Fax:434-974-9497
Practice Address - Street 1:300 HICKMAN RD
Practice Address - Street 2:SUITE 101
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-3554
Practice Address - Country:US
Practice Address - Phone:434-973-2520
Practice Address - Fax:434-974-9497
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014108911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice