| NPI | 1508385253 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON DASHOW Surgeon 907-222-5052 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery |
| Enumeration Date | 2017-09-13 |
| Last Update Date | 2022-07-21 |