Provider Demographics
NPI:1376645705
Name:DR CHRISTOPHER K GIAUQUE DDS PC
Entity type:Organization
Organization Name:DR CHRISTOPHER K GIAUQUE DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:KENT
Authorized Official - Last Name:GIAUQUE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:801-273-8100
Mailing Address - Street 1:1345 E 3900 S
Mailing Address - Street 2:STE 210
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84124
Mailing Address - Country:US
Mailing Address - Phone:801-273-8100
Mailing Address - Fax:801-273-8200
Practice Address - Street 1:1345 E 3900 S
Practice Address - Street 2:STE 210
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84124
Practice Address - Country:US
Practice Address - Phone:801-273-8100
Practice Address - Fax:801-273-8200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT47437789922122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty