| NPI | 1861681959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN MADDEN Office Administrator 907-488-0861 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AK 523) |
| Enumeration Date | 2007-10-15 |
| Last Update Date | 2007-10-15 |