Provider Demographics
NPI:1689731499
Name:CHRISTENSEN, KURT ANDREW (DDS)
Entity Type:Individual
Prefix:DR
First Name:KURT
Middle Name:ANDREW
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 1:337 W. MADISON
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020
Mailing Address - Country:US
Mailing Address - Phone:619-442-8841
Mailing Address - Fax:619-442-4214
Practice Address - Street 1:337 W. MADISON
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020
Practice Address - Country:US
Practice Address - Phone:619-442-8841
Practice Address - Fax:619-442-4214
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0125921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice