| NPI | 1568623106 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT HEBERTSON President 907-248-7275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 126800000X Dental Assistant (Licence: AK AA625) |
| Additional Taxonomies | 126800000X Dental Assistant (Licence: AK 1009) |
| Enumeration Date | 2008-06-17 |
| Last Update Date | 2008-06-17 |