Provider Demographics
NPI:1972949576
Name:MINNIGH, CHRISTOPHER ANDREW (DDS)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:ANDREW
Last Name:MINNIGH
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 1:1414 N KENNEDY AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74801-4700
Mailing Address - Country:US
Mailing Address - Phone:405-273-3270
Mailing Address - Fax:405-273-3467
Practice Address - Street 1:1414 N KENNEDY AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74801-4700
Practice Address - Country:US
Practice Address - Phone:405-273-3270
Practice Address - Fax:405-273-3467
Is Sole Proprietor?:No
Enumeration Date:2013-05-22
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6502122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist