| NPI | 1760741177 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE A JEDLICKA Dentist 907-260-4700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AK AK#1106) |
| Enumeration Date | 2012-05-07 |
| Last Update Date | 2012-05-07 |