| NPI | 1831550631 |
|---|---|
| Doing Business As | FAIRBANKS DENTAL CENTER |
| Entity Type | Organization |
| Authorized Contact | MICHAEL JOHN STOLTZ Partner 907-452-1250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 122300000X Dentist |
| 1223X2210X Dentist, Orofacial Pain | |
| Enumeration Date | 2016-03-08 |
| Last Update Date | 2023-11-03 |