Provider Demographics
NPI:1700044674
Name:HART, CHRISTOPHER DON (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:DON
Last Name:HART
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 1:240 E 23RD ST
Mailing Address - Street 2:
Mailing Address - City:MITCHELL
Mailing Address - State:SD
Mailing Address - Zip Code:57301-6440
Mailing Address - Country:US
Mailing Address - Phone:605-996-1316
Mailing Address - Fax:
Practice Address - Street 1:240 E 23RD ST
Practice Address - Street 2:
Practice Address - City:MITCHELL
Practice Address - State:SD
Practice Address - Zip Code:57301-6440
Practice Address - Country:US
Practice Address - Phone:605-996-1316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-28
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDTEMP #1361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice