| NPI | 1083213128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA ROSE MIZE Owner/Pediatric Dentist 907-222-2483 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2020-10-20 |
| Last Update Date | 2020-10-20 |