Provider Demographics
NPI:1962613851
Name:CHRISTENSEN, WILLIAM G (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:G
Last Name:CHRISTENSEN
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1375 E 800 N STE 204
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84097-4437
Mailing Address - Country:US
Mailing Address - Phone:801-226-6565
Mailing Address - Fax:801-226-1230
Practice Address - Street 1:1375 E 800 N STE 204
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84097-4437
Practice Address - Country:US
Practice Address - Phone:801-226-6565
Practice Address - Fax:801-226-1230
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics