Basic Information
| Provider Information | |||||||||
| NPI: | 1508069105 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PRICE | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | JOSEPH | ||||||||
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| Credential: | DDS, MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3473 W SOUTH JORDAN PKWY STE 4 | ||||||||
| Address2: | |||||||||
| City: | SOUTH JORDAN | ||||||||
| State: | UT | ||||||||
| PostalCode: | 840956016 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8014464428 | ||||||||
| FaxNumber: | 8017585658 | ||||||||
| Practice Location | |||||||||
| Address1: | 3473 W SOUTH JORDAN PKWY STE 4 | ||||||||
| Address2: | |||||||||
| City: | SOUTH JORDAN | ||||||||
| State: | UT | ||||||||
| PostalCode: | 840956016 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8014464428 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2007 | ||||||||
| LastUpdateDate: | 04/05/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/05/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223S0112X | 6922082-9924 | UT | Y | Dental Providers | Dentist | Oral and Maxillofacial Surgery |
No ID Information.