Provider Demographics
NPI:1205055159
Name:HAN R. CHRISTY DDS PC
Entity type:Organization
Organization Name:HAN R. CHRISTY DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:CHRISTY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:623-846-0329
Mailing Address - Street 1:4550 N 51ST AVE STE 17
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85031-1708
Mailing Address - Country:US
Mailing Address - Phone:623-846-0329
Mailing Address - Fax:623-946-3613
Practice Address - Street 1:4550 N 51ST AVE STE 17
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85031-1708
Practice Address - Country:US
Practice Address - Phone:623-846-0329
Practice Address - Fax:623-946-3613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2544122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty