Provider Demographics
NPI:1801257274
Name:DR. STEPHEN EUGENE CHRISTY D.M.D.
Entity type:Organization
Organization Name:DR. STEPHEN EUGENE CHRISTY D.M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY KAY
Authorized Official - Middle Name:
Authorized Official - Last Name:BOHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-645-6400
Mailing Address - Street 1:3707 WATSON RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63109-1236
Mailing Address - Country:US
Mailing Address - Phone:314-645-6400
Mailing Address - Fax:314-335-7080
Practice Address - Street 1:3707 WATSON RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63109-1236
Practice Address - Country:US
Practice Address - Phone:314-645-6400
Practice Address - Fax:314-335-7080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-14
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006007560122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty