| NPI | 1487923819 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES MICHAEL SAGE Owner/Dentist 907-562-2512 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AK 919176) |
| Enumeration Date | 2011-12-13 |
| Last Update Date | 2011-12-13 |