Provider Demographics
NPI:1710484357
Name:DAWSON, CHRISTOPHER THOMAS (DDS)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:THOMAS
Last Name:DAWSON
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 1:12330 NC HIGHWAY 210 STE 115
Mailing Address - Street 2:
Mailing Address - City:BENSON
Mailing Address - State:NC
Mailing Address - Zip Code:27504-5800
Mailing Address - Country:US
Mailing Address - Phone:919-207-2077
Mailing Address - Fax:919-934-1233
Practice Address - Street 1:12330 NC HIGHWAY 210 STE 115
Practice Address - Street 2:
Practice Address - City:BENSON
Practice Address - State:NC
Practice Address - Zip Code:27504-5800
Practice Address - Country:US
Practice Address - Phone:919-207-2077
Practice Address - Fax:919-934-1233
Is Sole Proprietor?:No
Enumeration Date:2018-04-10
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11474122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist