| NPI | 1083760896 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM R EVANS President 907-694-5150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AK 555) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2010-02-17 |