Provider Demographics
NPI:1760518989
Name:DELEDONNE, CHRISTOPHER JOSPEH (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JOSPEH
Last Name:DELEDONNE
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 1:1360 W 6TH ST STE 110
Mailing Address - Street 2:
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90732-3542
Mailing Address - Country:US
Mailing Address - Phone:310-833-4439
Mailing Address - Fax:310-833-4999
Practice Address - Street 1:1360 W 6TH ST STE 110
Practice Address - Street 2:
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90732-3542
Practice Address - Country:US
Practice Address - Phone:310-833-4439
Practice Address - Fax:310-833-4999
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA484461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice