Provider Demographics
NPI:1346485463
Name:DANDURAN, CHRISTOPHER (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:
Last Name:DANDURAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1383 21ST AVE N
Mailing Address - Street 2:SUITE A
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58102-1841
Mailing Address - Country:US
Mailing Address - Phone:701-365-0999
Mailing Address - Fax:701-298-3738
Practice Address - Street 1:1383 21ST AVE N
Practice Address - Street 2:SUITE A
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58102-1841
Practice Address - Country:US
Practice Address - Phone:701-365-0999
Practice Address - Fax:701-298-3738
Is Sole Proprietor?:No
Enumeration Date:2008-12-03
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND#829111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor