| NPI | 1659433738 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALTER L MOORHEAD Partner 907-874-3731 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AK 550) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AK 570) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2008-04-20 |