Provider Demographics
NPI:1689923898
Name:CHRISTMAN, RENA J (DMD)
Entity Type:Individual
Prefix:DR
First Name:RENA
Middle Name:J
Last Name:CHRISTMAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2509 COUNTY HWY I
Mailing Address - Street 2:
Mailing Address - City:CHIPPEWA
Mailing Address - State:WI
Mailing Address - Zip Code:54729
Mailing Address - Country:US
Mailing Address - Phone:715-403-4535
Mailing Address - Fax:715-726-1066
Practice Address - Street 1:2509 COUNTY HIGHWAY I
Practice Address - Street 2:
Practice Address - City:CHIPPEWA FALLS
Practice Address - State:WI
Practice Address - Zip Code:54729-1422
Practice Address - Country:US
Practice Address - Phone:715-403-4535
Practice Address - Fax:715-726-1066
Is Sole Proprietor?:No
Enumeration Date:2012-09-04
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6936-15122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist