Provider Demographics
NPI:1578655635
Name:BISHOP, CHRISTINE (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:
Last Name:BISHOP
Suffix:
Gender:F
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 E 116TH ST
Mailing Address - Street 2:102
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-3508
Mailing Address - Country:US
Mailing Address - Phone:317-574-0866
Mailing Address - Fax:317-574-0867
Practice Address - Street 1:2000 E 116TH ST
Practice Address - Street 2:102
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-3508
Practice Address - Country:US
Practice Address - Phone:317-574-0866
Practice Address - Fax:317-574-0867
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12009748122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist