Provider Demographics
NPI:1952458325
Name:CHRISTOPHER L. DURHAM DDS PA
Entity Type:Organization
Organization Name:CHRISTOPHER L. DURHAM DDS PA
Other - Org Name:THE ORAL SURGERY INSTITUTE OF THE CAROLINAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-275-6600
Mailing Address - Street 1:6 N POINTE CT STE 101
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-3187
Mailing Address - Country:US
Mailing Address - Phone:336-275-6600
Mailing Address - Fax:336-275-6699
Practice Address - Street 1:6 N POINTE CT STE 101
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-3187
Practice Address - Country:US
Practice Address - Phone:336-275-6600
Practice Address - Fax:336-275-6699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5921221Medicaid
NCT63786Medicare UPIN