Provider Demographics
NPI:1326105602
Name:SWISHER, CHRISTOPHER ALLEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:ALLEN
Last Name:SWISHER
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 1:1615 WOODS COURT
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-1355
Mailing Address - Country:US
Mailing Address - Phone:541-490-4993
Mailing Address - Fax:541-436-4418
Practice Address - Street 1:1615 WOODS COURT
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031
Practice Address - Country:US
Practice Address - Phone:541-490-4993
Practice Address - Fax:541-436-4418
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD-96981223P0221X
NY054845-11223P0221X
CA527841223P0221X
WADE000099731223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03305575Medicaid
OR500643081Medicaid