Provider Demographics
NPI:1194983486
Name:GRIFFIN, CHRISTOPHER AUSTIN (DDS)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:AUSTIN
Last Name:GRIFFIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 W MINNESOTA PARK RD
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-6125
Mailing Address - Country:US
Mailing Address - Phone:985-542-3368
Mailing Address - Fax:985-542-3335
Practice Address - Street 1:212 W MINNESOTA PARK RD
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-6125
Practice Address - Country:US
Practice Address - Phone:985-542-3368
Practice Address - Fax:985-542-3335
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-23
Last Update Date:2009-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5642122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist