Provider Demographics
NPI:1508028994
Name:CHRISTIAN, DAVID JOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JOSEPH
Last Name:CHRISTIAN
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 1:2902 59TH ST W
Mailing Address - Street 2:SUITE H
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-7023
Mailing Address - Country:US
Mailing Address - Phone:941-794-1788
Mailing Address - Fax:
Practice Address - Street 1:2902 59TH ST W
Practice Address - Street 2:SUITE H
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-7023
Practice Address - Country:US
Practice Address - Phone:941-794-1788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-27
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA302561223S0112X
FLDN196161223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery