| NPI | 1437568409 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENLEY DANE MICHAUD CEO 907-268-3109 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: AK 1547) |
| Enumeration Date | 2014-08-04 |
| Last Update Date | 2014-08-04 |