Provider Demographics
NPI:1134432784
Name:HIGGINS, CHRISTINE A (DMD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:A
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1253 COCOA AVE
Mailing Address - Street 2:
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-1715
Mailing Address - Country:US
Mailing Address - Phone:717-534-2985
Mailing Address - Fax:717-520-1400
Practice Address - Street 1:1253 COCOA AVE
Practice Address - Street 2:
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-1715
Practice Address - Country:US
Practice Address - Phone:717-534-2985
Practice Address - Fax:717-520-1400
Is Sole Proprietor?:No
Enumeration Date:2010-07-23
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN001040122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1931333OtherUNITED CONCORDIA PROVIDER ID