Individual
DR. CHRISTOPHER MARK CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS PC
Contact information
Practice address
3520 UTICA RIDGE ROAD, BETTENDORF, IA 52722
(563) 359-9165
(563) 359-1824
Mailing address
3520 UTICA RIDGE ROAD, BETTENDORF, IA 52722
(563) 359-9165
(563) 359-1824
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7498
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1001390
—
IL
05
—
1074351
—
IA
Enumeration date
03/30/2006
Last updated
08/27/2012
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