| NPI | 1619190980 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN R LIBBY Dentist Owner 907-337-9434 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AK 0582) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2020-08-22 |