| NPI | 1669954483 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAGGIE B MATHESON Operations Manager 907-455-4350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AK 115692) |
| Enumeration Date | 2018-08-29 |
| Last Update Date | 2018-08-29 |