| NPI | 1871702688 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD CHARLES GREGORIN Member 907-333-2061 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: AK 1034) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2007-07-23 |