Individual
WAYNE EARL CHRISTIANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1616 30TH AVE S, MOORHEAD, MN 56560-5152
(218) 233-4267
Mailing address
3611 RIVERSHORE DR, MOORHEAD, MN 56560-5556
(218) 236-7697
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9145
MN
Other
Enumeration date
05/01/2006
Last updated
09/05/2012
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