DEREK S SIMON

NOME, AK
NPI1760759245
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy124Q00000X Dental Hygienist
(Licence: AK  07-045-EFDHA I)
Enumeration Date2011-11-28
Last Update Date2011-11-28
Business Address
-- DEREK S SIMON DHA
306 WEST FIFTH AVENUE
NOME, AK 99762
Phone number: 907-443-3309
Mailing Address
-- DEREK S SIMON DHA
PO BOX 966
NOME, AK 99762-0966
Phone number: 907-443-3309
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