| NPI | 1720105034 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY HENRY DOSTAL Owner 907-586-3068 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2007-11-29 |