Provider Demographics
NPI:1831127174
Name:CHRISTOPHER, JEFFREY SCOTT (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:SCOTT
Last Name:CHRISTOPHER
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 1:600 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:FAIR HAVEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07704-3221
Mailing Address - Country:US
Mailing Address - Phone:732-842-1089
Mailing Address - Fax:732-842-3223
Practice Address - Street 1:600 RIVER RD
Practice Address - Street 2:
Practice Address - City:FAIR HAVEN
Practice Address - State:NJ
Practice Address - Zip Code:07704-3221
Practice Address - Country:US
Practice Address - Phone:732-842-1089
Practice Address - Fax:732-842-3223
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-28
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI019790001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice