Provider Demographics
NPI:1265839575
Name:LANDES, CHRISTINE MARIE (DMD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:MARIE
Last Name:LANDES
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:MARIE
Other - Last Name:MACELROY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:46 BLACKSMITH RD
Mailing Address - Street 2:SUITE TOOTH
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1847
Mailing Address - Country:US
Mailing Address - Phone:215-504-5437
Mailing Address - Fax:
Practice Address - Street 1:46 BLACKSMITH RD
Practice Address - Street 2:SUITE TOOTH
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1847
Practice Address - Country:US
Practice Address - Phone:215-504-5437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-02
Last Update Date:2014-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0293551223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry