| NPI | 1750604195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZONA MAE MULLINS Office Manager 907-561-2475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AK 697) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: AK 683) |
| 1223G0001X Dentist General Practice (Licence: AK 1327) | |
| Enumeration Date | 2010-03-11 |
| Last Update Date | 2010-03-11 |