Provider Demographics
NPI:1831226125
Name:VON TERSCH, CHRISTOPHER JOHN (DDS)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:JOHN
Last Name:VON TERSCH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:6056 RIVERBANK CIR
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95219-2522
Mailing Address - Country:US
Mailing Address - Phone:209-477-0223
Mailing Address - Fax:209-477-0226
Practice Address - Street 1:3453 BROOKSIDE RD STE B
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95219-1788
Practice Address - Country:US
Practice Address - Phone:209-477-0223
Practice Address - Fax:209-477-0226
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA467101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice