| NPI | 1659627693 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARRINER RUSSELL MORRELL President/Owner 907-277-6724 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AK 1058) |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2012-07-27 |
| Last Update Date | 2012-07-27 |