Provider Demographics
NPI:1770006231
Name:CHRISTENSON, ERIC VO (DDS)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:VO
Last Name:CHRISTENSON
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 1:165 19TH ST S STE 101
Mailing Address - Street 2:
Mailing Address - City:SARTELL
Mailing Address - State:MN
Mailing Address - Zip Code:56377-2567
Mailing Address - Country:US
Mailing Address - Phone:320-253-9270
Mailing Address - Fax:
Practice Address - Street 1:165 19TH ST S STE 101
Practice Address - Street 2:
Practice Address - City:SARTELL
Practice Address - State:MN
Practice Address - Zip Code:56377-2567
Practice Address - Country:US
Practice Address - Phone:320-253-9270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND138951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice