Provider Demographics
NPI:1205002474
Name:DAMM, CHRISTIE ANN-ROSENBERRY (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIE
Middle Name:ANN-ROSENBERRY
Last Name:DAMM
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:CHRISTIE
Other - Middle Name:ANN
Other - Last Name:ROSENBERRY DAMM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:45569 VAN DYKE
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:MI
Mailing Address - Zip Code:48317
Mailing Address - Country:US
Mailing Address - Phone:586-731-8250
Mailing Address - Fax:586-731-2315
Practice Address - Street 1:45569 VAN DYKE
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:MI
Practice Address - Zip Code:48317
Practice Address - Country:US
Practice Address - Phone:586-731-8250
Practice Address - Fax:586-731-2315
Is Sole Proprietor?:No
Enumeration Date:2008-05-07
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901016306122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist