Provider Demographics
NPI:1942429956
Name:KEMP, CHRISTOPHER F (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:F
Last Name:KEMP
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 1:805 S BROADWAY ST STE 205
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80305-5972
Mailing Address - Country:US
Mailing Address - Phone:303-543-7615
Mailing Address - Fax:303-543-8432
Practice Address - Street 1:805 S BROADWAY ST STE 205
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80305-5972
Practice Address - Country:US
Practice Address - Phone:303-543-7615
Practice Address - Fax:303-543-8432
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.002019411223G0001X
ND18251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND40732Medicaid
MT110585Medicaid