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Individual
DR. KIRK CHRISTIANSON
Active
Individual
DR. KIRK CHRISTIANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
FC3623053
OR
1223G0001X
General Practice Dentistry
D9563
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1568585594
NPI
OR
01
—
FC3623053
STATE LICENSE
OR
Enumeration date
04/06/2007
Last updated
07/21/2022
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