Provider Demographics
NPI:1174604110
Name:BLIXRUD, CHRIS ALLAN (DDS)
Entity type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:ALLAN
Last Name:BLIXRUD
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 1:601 1ST AVE N
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59401-2510
Mailing Address - Country:US
Mailing Address - Phone:406-454-6973
Mailing Address - Fax:406-791-9277
Practice Address - Street 1:202 2ND AVE S STE 203
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-1831
Practice Address - Country:US
Practice Address - Phone:406-791-9267
Practice Address - Fax:406-454-7724
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN10403122300000X
MTDEN-DEN-LIC-9751122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN296722700OtherMN MEDICAL ASS
MN296722700OtherMN MEDICAL ASS