Provider Demographics
NPI:1437409869
Name:CHRISTENSEN, DAYLE LYNN (RDJ)
Entity Type:Individual
Prefix:MS
First Name:DAYLE
Middle Name:LYNN
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:RDJ
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:0680 COUNTY RD 294
Mailing Address - Street 2:
Mailing Address - City:RIFLE
Mailing Address - State:CO
Mailing Address - Zip Code:81650
Mailing Address - Country:US
Mailing Address - Phone:970-625-1758
Mailing Address - Fax:
Practice Address - Street 1:1430 RAILROAD AVE SUITE B
Practice Address - Street 2:
Practice Address - City:RIFLE
Practice Address - State:CO
Practice Address - Zip Code:81650
Practice Address - Country:US
Practice Address - Phone:970-625-1696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-13
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2509124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist