Provider Demographics
NPI:1730307604
Name:ABERNATHY, CHRISTINA BLANTON (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:BLANTON
Last Name:ABERNATHY
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 1:1000 S STERLING ST
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-3938
Mailing Address - Country:US
Mailing Address - Phone:828-433-2335
Mailing Address - Fax:828-430-7898
Practice Address - Street 1:1000 S STERLING ST
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-3938
Practice Address - Country:US
Practice Address - Phone:828-433-2335
Practice Address - Fax:828-430-7898
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC61771223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8998109Medicaid