| NPI | 1720202187 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENE PELTOLA CEO 907-543-6020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist Endodontics |
| Additional Taxonomies | 1223G0001X Dentist General Practice |
| 1223P0221X Dentist Pediatric Dentistry | |
| 1223P0300X Dentist Periodontics | |
| 1223P0700X Dentist Prosthodontics | |
| 1223S0112X Dentist Oral and Maxillofacial Surgery | |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2008-03-03 |