Provider Demographics
NPI:1760716005
Name:COMFORT, CHRISTOPHER JOHN (DDS, FAGD, AAACD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JOHN
Last Name:COMFORT
Suffix:
Gender:M
Credentials:DDS, FAGD, AAACD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:POB 3261
Mailing Address - Street 2:
Mailing Address - City:MAMMOTH LAKES
Mailing Address - State:CA
Mailing Address - Zip Code:93546
Mailing Address - Country:US
Mailing Address - Phone:760-934-3730
Mailing Address - Fax:775-738-6815
Practice Address - Street 1:170 MOUNTAIN BOULEVARD
Practice Address - Street 2:
Practice Address - City:MAMMOTH LAKES
Practice Address - State:CA
Practice Address - Zip Code:93546
Practice Address - Country:US
Practice Address - Phone:760-934-3730
Practice Address - Fax:775-738-6815
Is Sole Proprietor?:No
Enumeration Date:2009-09-18
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA035089122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist