Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204E00000X | Oral & Maxillofacial Surgeon | 138473 | UT |
NPI | 1376607721 |
---|---|
Provider Name | Dr. Steven E Christensen |
First Address | Salt Lake City, UT 84123 |
Second Address | Salt Lake City, UT 84123 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T48840 | (02) |