| NPI | 1336391515 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN MORGAN FABER Owner / President 907-486-3257 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: AK 1179) |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2008-10-21 |