Individual
DR. CHAD CHRISTIANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2120 LOGAN AVE, CHEYENNE, WY 82001-4131
(307) 638-8071
Mailing address
2120 LOGAN AVE, CHEYENNE, WY 82001-4131
(307) 638-8071
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1541
WY
1223G0001X
General Practice Dentistry
7397
NE
Other
Enumeration date
06/22/2017
Last updated
02/03/2021
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