Individual
DR. CHRISTIAN A PEABODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2201 S. GETTY STREET, MUSKEGON HTS., MI 49444-1207
(231) 767-9830
(231) 773-2454
Mailing address
2201 S. GETTY STREET, MUSKEGON HEIGHTS, MI 49444-1207
(231) 767-9830
(231) 773-2454
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901011507
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
115070
DENTAL PROVIDER BCBS
MI
05
—
12-3138796
—
MI
05
—
12-4044943
—
MI
01
—
443416
DENTAL PRVDR.# FOR UCCI
MI
01
—
913785
DENTAL PRVDR.# FOR UCCI
MI
Enumeration date
06/28/2005
Last updated
10/27/2015
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