Individual
DR. CHRISTOPHER ERIC WACKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
25884 BUSINESS CENTER DRIVE #F, REDLANDS, CA 92374
(909) 796-2507
(909) 796-3247
Mailing address
25884 BUSINESS CENTER DRIVE #F, REDLANDS, CA 92374
(909) 796-2507
(909) 796-3247
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
43267
CA
1223P0221X
Pediatric Dentistry
43267
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
855677
UNITED CONCORDIA
CA
01
—
900136449
TAX ID
CA
Enumeration date
07/17/2006
Last updated
11/29/2021
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