Provider Demographics
NPI:1801925581
Name:KAY B. CHRISTENSEN,DDS,PC
Entity type:Organization
Organization Name:KAY B. CHRISTENSEN,DDS,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAY
Authorized Official - Middle Name:B
Authorized Official - Last Name:CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:435-257-5678
Mailing Address - Street 1:718 E MAIN ST
Mailing Address - Street 2:POB 146
Mailing Address - City:TREMONTON
Mailing Address - State:UT
Mailing Address - Zip Code:84337-2326
Mailing Address - Country:US
Mailing Address - Phone:435-257-5678
Mailing Address - Fax:435-257-1743
Practice Address - Street 1:718 E MAIN ST
Practice Address - Street 2:POB 146
Practice Address - City:TREMONTON
Practice Address - State:UT
Practice Address - Zip Code:84337-2326
Practice Address - Country:US
Practice Address - Phone:435-257-5678
Practice Address - Fax:435-257-1743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14411699221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty