Provider Demographics
NPI:1275724189
Name:CHRISTENSEN, JOSEPH D (DMD, MS)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:D
Last Name:CHRISTENSEN
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 W CRENSHAW CT
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:UT
Mailing Address - Zip Code:84045-6434
Mailing Address - Country:US
Mailing Address - Phone:801-367-0640
Mailing Address - Fax:
Practice Address - Street 1:36 S 1100 E
Practice Address - Street 2:
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-2835
Practice Address - Country:US
Practice Address - Phone:801-822-9876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-06
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5134480-99211223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics