| NPI | 1144508128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER WILLIS Director Of Operations 907-687-3491 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AK 1252) |
| Enumeration Date | 2011-07-25 |
| Last Update Date | 2011-07-25 |