| NPI | 1215437165 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEONARDO MANUEL RIOS-ANDERSEN Oral Surgeon 907-726-5600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery |
| Enumeration Date | 2018-02-16 |
| Last Update Date | 2018-07-26 |