Provider Demographics
NPI:1558103713
Name:HYNUM, CHRISTOPHER LANE (DMD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:LANE
Last Name:HYNUM
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:814 PINE CIR
Mailing Address - Street 2:
Mailing Address - City:STARKVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39759-3732
Mailing Address - Country:US
Mailing Address - Phone:601-618-0838
Mailing Address - Fax:
Practice Address - Street 1:611 LEIGH DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39705-3036
Practice Address - Country:US
Practice Address - Phone:662-328-1825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS4460-24122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist