| NPI | 1336518349 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA BLANCO President/Doctor 907-523-5437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: AK 104062) |
| Enumeration Date | 2015-09-20 |
| Last Update Date | 2023-02-24 |