Individual
EUGENE W CHRISTENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
985 DAHLIA & WEST 10TH AVE., ANTONITO, CO 81120
(719) 376-2295
Mailing address
PO BOX 768, ANTONITO, CO 81120-0768
(719) 376-2295
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
HD104005
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02040053
—
CO
Enumeration date
08/14/2008
Last updated
08/14/2008
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