| NPI | 1437281094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS S WEAVER President 907-586-3220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AK 492) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2020-08-22 |