| NPI | 1376982918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA WOLLER Orthodontist 907-452-2939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: AK 1249) |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2013-06-17 |