Provider Demographics
NPI:1699140806
Name:SIDNEY H CHRISTIE, DMD
Entity type:Organization
Organization Name:SIDNEY H CHRISTIE, DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SIDNEY
Authorized Official - Middle Name:HOLLAND
Authorized Official - Last Name:CHRISTIE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:239-997-7787
Mailing Address - Street 1:5163 ORANGE GROVE BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33903-5230
Mailing Address - Country:US
Mailing Address - Phone:239-997-7787
Mailing Address - Fax:
Practice Address - Street 1:5163 ORANGE GROVE BLVD
Practice Address - Street 2:
Practice Address - City:NORTH FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33903-5230
Practice Address - Country:US
Practice Address - Phone:239-997-7787
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-14
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty