Provider Demographics
NPI:1164723474
Name:CHRISTIAN SANTANA D D S P C
Entity Type:Organization
Organization Name:CHRISTIAN SANTANA D D S P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:F
Authorized Official - Last Name:SANTANA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:570-497-4081
Mailing Address - Street 1:21 E BROAD ST STE C
Mailing Address - Street 2:
Mailing Address - City:HAZLETON
Mailing Address - State:PA
Mailing Address - Zip Code:18201-6511
Mailing Address - Country:US
Mailing Address - Phone:570-497-4081
Mailing Address - Fax:570-497-4082
Practice Address - Street 1:21 E BROAD ST STE C
Practice Address - Street 2:
Practice Address - City:HAZLETON
Practice Address - State:PA
Practice Address - Zip Code:18201-6511
Practice Address - Country:US
Practice Address - Phone:570-497-4081
Practice Address - Fax:570-497-4082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-03
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Single Specialty