| NPI | 1780706838 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN J SCHULTZ Dentist Vice President 907-586-9885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AK 963) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO 7435) |
| 122300000X Dentist (Licence: CO 7113) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AK 961) | |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2014-02-04 |