| NPI | 1316147069 |
|---|---|
| Doing Business As | NORTH STAR DENTAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | KELLEY BAKER Health Services Division Director 907-562-4155 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2021-12-16 |