Provider Demographics
NPI:1124219555
Name:SASIK, CHRISTOPHER THOMAS (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:THOMAS
Last Name:SASIK
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 1:3455 PLYMOUTH BLVD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55447-1540
Mailing Address - Country:US
Mailing Address - Phone:763-559-7600
Mailing Address - Fax:763-559-7604
Practice Address - Street 1:3455 PLYMOUTH BLVD
Practice Address - Street 2:SUITE 250
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55447-1540
Practice Address - Country:US
Practice Address - Phone:763-559-7600
Practice Address - Fax:763-559-7604
Is Sole Proprietor?:No
Enumeration Date:2007-08-09
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND107561223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics