Provider Demographics
NPI:1114042272
Name:DETURE, CHRISTOPHER NICHOLAS (DMD)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:NICHOLAS
Last Name:DETURE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 EAST HILLSBORO BOULEVARD
Mailing Address - Street 2:101
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441
Mailing Address - Country:US
Mailing Address - Phone:954-427-5700
Mailing Address - Fax:954-427-5990
Practice Address - Street 1:1500 EAST HILLSBORO BLVD.
Practice Address - Street 2:#101
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441
Practice Address - Country:US
Practice Address - Phone:954-427-5700
Practice Address - Fax:954-427-5990
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN14431122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist