| NPI | 1851664858 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETT MICHAEL GARDINER Owner/Dentist 907-561-3639 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AK 875) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: AK 253) |
| 1223G0001X Dentist General Practice (Licence: AK 1274) | |
| Enumeration Date | 2012-02-22 |
| Last Update Date | 2012-02-22 |