Provider Demographics
NPI:1851585178
Name:HARPER, CHRISTOPHER KEITH (DMD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:KEITH
Last Name:HARPER
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 1:1724 GUNTER AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:GUNTERSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35976-1822
Mailing Address - Country:US
Mailing Address - Phone:256-582-2248
Mailing Address - Fax:
Practice Address - Street 1:1724 GUNTER AVE
Practice Address - Street 2:SUITE A
Practice Address - City:GUNTERSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35976-1822
Practice Address - Country:US
Practice Address - Phone:256-582-2248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-29
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5576122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL993983OtherUNITED CONCORDIA