Provider Demographics
NPI:1750700837
Name:GURRIES, CHRISTOPHER (DDS)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:
Last Name:GURRIES
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 1:633D MDG ORAL AND MAXILLOFACIAL SURGERY
Mailing Address - Street 2:77 NEALY AVE
Mailing Address - City:LANGLEY AFB
Mailing Address - State:VA
Mailing Address - Zip Code:23665
Mailing Address - Country:US
Mailing Address - Phone:757-764-7124
Mailing Address - Fax:
Practice Address - Street 1:450 SUTTER ST RM 2439
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-4208
Practice Address - Country:US
Practice Address - Phone:415-956-6610
Practice Address - Fax:415-956-6618
Is Sole Proprietor?:No
Enumeration Date:2014-04-16
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA635261223S0112X, 204E00000X
VA04014164511223S0112X
171000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No171000000XOther Service ProvidersMilitary Health Care Provider
No204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery