| NPI | 1174709927 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW ANTHONY WELCH Member 907-357-3414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AK 1159) |
| Enumeration Date | 2008-01-10 |
| Last Update Date | 2008-01-10 |