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Individual

DR. COREY D. CHRISTENSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
2205 CHANNING WAY, IDAHO FALLS, ID 83404-8016
(208) 529-3660
(208) 529-3666
Mailing address
3805 HIDDEN HAVEN ST, AMMON, ID 83406-7522
(208) 524-4020

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D3703
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1482771
UNITED CONCORDIA
ID
01
6I310
BLUE CROSS OF IDAHO
ID
05
806625301
ID
Enumeration date
11/07/2006
Last updated
07/09/2007
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