Provider Demographics
NPI:1750027397
Name:ETIENNE, MEDGINE CHRISTIE (DDS)
Entity type:Individual
Prefix:DR
First Name:MEDGINE
Middle Name:CHRISTIE
Last Name:ETIENNE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7180 NC 73 HWY
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:NC
Mailing Address - Zip Code:28037-9186
Mailing Address - Country:US
Mailing Address - Phone:980-375-1290
Mailing Address - Fax:
Practice Address - Street 1:7180 NC 73 HWY
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:NC
Practice Address - Zip Code:28037-9186
Practice Address - Country:US
Practice Address - Phone:980-375-1290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-06
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY063405122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist