Provider Demographics
NPI:1720292428
Name:ELLIOTT, CHRISTOPHER EDWARD (DDS)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:EDWARD
Last Name:ELLIOTT
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 1:16315 WHITTIER BLVD
Mailing Address - Street 2:STE. # 203
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90603-2908
Mailing Address - Country:US
Mailing Address - Phone:562-943-0234
Mailing Address - Fax:
Practice Address - Street 1:16315 WHITTIER BLVD
Practice Address - Street 2:STE. # 203
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90603-2908
Practice Address - Country:US
Practice Address - Phone:562-943-0234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA357161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice