| NPI | 1609055029 |
|---|---|
| Doing Business As | FOUR CORNERS DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | PETE B. HIGGINS Managing Member 907-479-7771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: AK 1012) |
| Enumeration Date | 2007-11-01 |
| Last Update Date | 2007-11-01 |