| NPI | 1093123879 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN DAVID PAULSON Dentist 907-452-8296 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AK 1572) |
| Enumeration Date | 2014-07-24 |
| Last Update Date | 2014-07-24 |