| NPI | 1093213167 |
|---|---|
| Other Name | FAMILY DENTISTRY OF KODIAK |
| Entity Type | Organization |
| Authorized Contact | MICHAEL PFEFFER Chief Operating Officer 907-486-9800 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2018-01-24 |
| Last Update Date | 2018-01-24 |