Provider Demographics
NPI:1689754608
Name:GRIFFIN, CHRISTOPHER THOMAS (DMDZ)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:THOMAS
Last Name:GRIFFIN
Suffix:
Gender:M
Credentials:DMDZ
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 W CAMBRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29646-2234
Mailing Address - Country:US
Mailing Address - Phone:864-229-2610
Mailing Address - Fax:864-229-3323
Practice Address - Street 1:150 W CAMBRIDGE AVE
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29646-2234
Practice Address - Country:US
Practice Address - Phone:864-229-2610
Practice Address - Fax:864-229-3323
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice