Provider Demographics
NPI:1205878717
Name:PAZANDAK, CHRISTOPHER L (DDS)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:L
Last Name:PAZANDAK
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 1:1593 PUCKER ST
Mailing Address - Street 2:
Mailing Address - City:STOWE
Mailing Address - State:VT
Mailing Address - Zip Code:05672-4579
Mailing Address - Country:US
Mailing Address - Phone:802-253-4157
Mailing Address - Fax:802-253-7025
Practice Address - Street 1:1593 PUCKER ST
Practice Address - Street 2:
Practice Address - City:STOWE
Practice Address - State:VT
Practice Address - Zip Code:05672-4579
Practice Address - Country:US
Practice Address - Phone:802-253-4157
Practice Address - Fax:802-253-7025
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT11361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice