Provider Demographics
NPI:1013393248
Name:FLINT, CHRISTOPHER (DMD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:FLINT
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:CHRIS
Other - Middle Name:
Other - Last Name:FLINT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:2700 S HIGHWAY 191 STE 1
Mailing Address - Street 2:
Mailing Address - City:MOAB
Mailing Address - State:UT
Mailing Address - Zip Code:84532-3443
Mailing Address - Country:US
Mailing Address - Phone:435-259-5378
Mailing Address - Fax:
Practice Address - Street 1:2700 S HIGHWAY 191 STE 1
Practice Address - Street 2:
Practice Address - City:MOAB
Practice Address - State:UT
Practice Address - Zip Code:84532-3443
Practice Address - Country:US
Practice Address - Phone:435-259-5378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-11
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9455890-99221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice