| NPI | 1104358373 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT P PIERSON Owner 907-336-8478 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AK DEND971) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AK DEND971) |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2017-03-29 |