Provider Demographics
NPI:1881338457
Name:PRITCHARD, CHRISTOPHER PHILIP
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:PHILIP
Last Name:PRITCHARD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3866 WARD AVE
Mailing Address - Street 2:
Mailing Address - City:SPEARFISH
Mailing Address - State:SD
Mailing Address - Zip Code:57783-7702
Mailing Address - Country:US
Mailing Address - Phone:605-933-9168
Mailing Address - Fax:
Practice Address - Street 1:19026 US HIGHWAY 85
Practice Address - Street 2:
Practice Address - City:BELLE FOURCHE
Practice Address - State:SD
Practice Address - Zip Code:57717-3110
Practice Address - Country:US
Practice Address - Phone:605-892-3603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-20
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDD13591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice