Provider Demographics
NPI:1134435597
Name:PEEKE, CHRISTOPHER BRENT (DDS)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:BRENT
Last Name:PEEKE
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 1:264 N HIGHLAND SPRINGS AVE
Mailing Address - Street 2:SUITE 5B
Mailing Address - City:BANNING
Mailing Address - State:CA
Mailing Address - Zip Code:92220-3082
Mailing Address - Country:US
Mailing Address - Phone:951-845-4685
Mailing Address - Fax:
Practice Address - Street 1:264 N HIGHLAND SPRINGS AVE
Practice Address - Street 2:SUITE 5B
Practice Address - City:BANNING
Practice Address - State:CA
Practice Address - Zip Code:92220-3082
Practice Address - Country:US
Practice Address - Phone:951-845-4685
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-24
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64297122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist