Provider Demographics
NPI:1073740593
Name:MEEHAN, CHRISTOPHER K (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:K
Last Name:MEEHAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 SAINT ANDREWS CT STE 1120
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-8819
Mailing Address - Country:US
Mailing Address - Phone:507-345-4259
Mailing Address - Fax:507-345-4460
Practice Address - Street 1:151 SAINT ANDREWS CT STE 1120
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-8819
Practice Address - Country:US
Practice Address - Phone:507-345-4259
Practice Address - Fax:507-345-4460
Is Sole Proprietor?:No
Enumeration Date:2009-06-11
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN12711122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist