Individual
TYLER CRAIG CHRISTIANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
6958 NEBRASKA AVE BLDG 1608, FORT LEONARD WOOD, MO 65473-1618
(573) 596-0364
Mailing address
4430 MISSOURI AVE, FORT LEONARD WOOD, MO 65473-9098
(573) 596-0417
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2023023294
MO
Other
Enumeration date
07/28/2023
Last updated
04/12/2024
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