NPI | 1538557640 |
---|---|
Entity Type | Organization |
Authorized Contact | CHUCK SKINNER Owner 907-350-3815 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: CO 10514) |
Additional Taxonomies | 122300000X Dentist (Licence: CO 10093) |
Enumeration Date | 2014-12-26 |
Last Update Date | 2014-12-26 |