Provider Demographics
NPI:1013301597
Name:CHRISTOPHER A SWISHER, DDS, PC
Entity Type:Organization
Organization Name:CHRISTOPHER A SWISHER, DDS, PC
Other - Org Name:LITTLE SHREDDERS DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PEDIATRIC DENTIST
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:A
Authorized Official - Last Name:SWISHER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:541-490-4993
Mailing Address - Street 1:1615 WOODS COURT
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031
Mailing Address - Country:US
Mailing Address - Phone:541-490-4993
Mailing Address - Fax:541-436-4418
Practice Address - Street 1:1615 WOODS COURT
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031
Practice Address - Country:US
Practice Address - Phone:541-490-4993
Practice Address - Fax:541-436-4418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-24
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR96981223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500643081Medicaid