Provider Demographics
NPI:1609165406
Name:HUNTINGTON, CHRIS (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:
Last Name:HUNTINGTON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:CHRISTOPHER
Other - Middle Name:J
Other - Last Name:HUNTINGTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:801 N WILMOT RD
Mailing Address - Street 2:BUILDING C
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-1711
Mailing Address - Country:US
Mailing Address - Phone:520-745-5187
Mailing Address - Fax:520-207-2284
Practice Address - Street 1:801 N WILMOT RD
Practice Address - Street 2:BUILDING C
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-1711
Practice Address - Country:US
Practice Address - Phone:520-745-5187
Practice Address - Fax:520-207-2284
Is Sole Proprietor?:No
Enumeration Date:2011-04-01
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD8017122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist