| NPI | 1871175455 |
|---|---|
| Doing Business As | DENTAL- DENTAL SURGERY CENTER |
| Entity Type | Organization |
| Authorized Contact | RONALD LEE OLSON Executive Vice President Finance 907-729-4939 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| 261QM2500X Clinic/Center, Medical Specialty | |
| Enumeration Date | 2021-04-23 |
| Last Update Date | 2026-04-01 |