| NPI | 1770809519 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES MICHAEL SAGE Owner/Dentist 907-373-8455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AK 939) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: AK 1320) |
| Enumeration Date | 2010-04-19 |
| Last Update Date | 2010-04-19 |