Provider Demographics
NPI:1326526518
Name:CHRIS R. CHAPMAN LD, PC
Entity type:Organization
Organization Name:CHRIS R. CHAPMAN LD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTURIST
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:CHAPMAN
Authorized Official - Last Name:LD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-386-2012
Mailing Address - Street 1:926 12TH ST
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-1538
Mailing Address - Country:US
Mailing Address - Phone:541-386-2012
Mailing Address - Fax:541-387-2012
Practice Address - Street 1:926 12TH ST
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031
Practice Address - Country:US
Practice Address - Phone:541-386-2012
Practice Address - Fax:541-387-2012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-31
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDT-DO-663650122400000X
ORDT-DO-10179741122400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122400000XDental ProvidersDenturistGroup - Single Specialty