Provider Demographics
NPI:1578687125
Name:CHRISTENSEN, ROBERT EMIL (DDS)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:EMIL
Last Name:CHRISTENSEN
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 1:2303 W LOUISIANA AVE
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79701-5800
Mailing Address - Country:US
Mailing Address - Phone:432-684-7424
Mailing Address - Fax:432-570-6181
Practice Address - Street 1:2303 W LOUISIANA AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-5800
Practice Address - Country:US
Practice Address - Phone:432-684-7424
Practice Address - Fax:432-570-6181
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD-118871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice