| NPI | 1841533155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN M EASLEY President 907-248-0022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AK 994) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2013-04-04 |
| Last Update Date | 2013-09-26 |