Provider Demographics
NPI:1992327431
Name:RYANN MICHELLE CHRISTENSEN, DDS, MS, PC
Entity type:Organization
Organization Name:RYANN MICHELLE CHRISTENSEN, DDS, MS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RYANN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:559-301-4597
Mailing Address - Street 1:1642 E HERNDON AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-3377
Mailing Address - Country:US
Mailing Address - Phone:559-261-2055
Mailing Address - Fax:
Practice Address - Street 1:1642 E HERNDON AVE STE 105
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3377
Practice Address - Country:US
Practice Address - Phone:559-261-2055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-07
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental