Organization
GORDON J. CHRISTENSEN DDS PHD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MISTY GAYLE WILSON RDH (OFFICE MANAGER)
(801) 226-5315
Entity
Organization
Contact information
Practice address
3707 N CANYON RD, SUITE 4, PROVO, UT 84604-4592
(801) 226-5315
(801) 655-1950
Mailing address
3707 N CANYON RD STE 4, PROVO, UT 84604-4587
(801) 226-5315
(801) 655-1950
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
137010
UT
Other
Enumeration date
04/12/2016
Last updated
04/12/2016
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