Provider Demographics
NPI:1760536049
Name:FORSTER, CHRISTOPHER MATTHEW (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:MATTHEW
Last Name:FORSTER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 OLD BEACH RD
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:RI
Mailing Address - Zip Code:02840-3285
Mailing Address - Country:US
Mailing Address - Phone:401-619-1888
Mailing Address - Fax:401-619-5166
Practice Address - Street 1:15 OLD BEACH RD
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:RI
Practice Address - Zip Code:02840-3285
Practice Address - Country:US
Practice Address - Phone:401-619-1888
Practice Address - Fax:401-619-5166
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDEN028351223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIZQA273OtherBLUE CROSS BLUE SHIELD MA
RI1635275OtherTRICARE
RI8494-3OtherBLUE CROSS BLUE SHIELD RI