Provider Demographics
NPI:1659706927
Name:JOHN J CHRISTENSEN DDS PC
Entity Type:Organization
Organization Name:JOHN J CHRISTENSEN DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:JUAL
Authorized Official - Last Name:CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:801-444-0303
Mailing Address - Street 1:700 N FAIRFIELD RD
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-2728
Mailing Address - Country:US
Mailing Address - Phone:801-444-0303
Mailing Address - Fax:801-546-0652
Practice Address - Street 1:700 N FAIRFIELD RD
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-2728
Practice Address - Country:US
Practice Address - Phone:801-444-0303
Practice Address - Fax:801-546-0652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-05
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental