| NPI | 1013084680 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALT BABULA President Orthodontist 907-452-2939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: AK AK9) |
| Additional Taxonomies | 122300000X Dentist (Licence: AK AK330) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2013-08-07 |