Provider Demographics
NPI:1437331584
Name:NORDLANDER, KRISTA ANNE (DDS)
Entity Type:Individual
Prefix:DR
First Name:KRISTA
Middle Name:ANNE
Last Name:NORDLANDER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1535 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02724-2605
Mailing Address - Country:US
Mailing Address - Phone:508-235-0488
Mailing Address - Fax:508-235-0444
Practice Address - Street 1:1535 S MAIN ST
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02724-2605
Practice Address - Country:US
Practice Address - Phone:508-235-0488
Practice Address - Fax:508-235-0444
Is Sole Proprietor?:No
Enumeration Date:2007-11-30
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA166451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice