Provider Demographics
NPI:1356029920
Name:ALDER, CHRISTINE ISABELLA (DDS)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:ISABELLA
Last Name:ALDER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:CHRISTINE
Other - Middle Name:ISABELLA
Other - Last Name:SCANLAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:3101 CRESCENT DR APT 315
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-1076
Mailing Address - Country:US
Mailing Address - Phone:308-631-1834
Mailing Address - Fax:
Practice Address - Street 1:4000 E CAMPUS LOOP S
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68583-1530
Practice Address - Country:US
Practice Address - Phone:402-472-1333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-05
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7903122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist