| NPI | 1902186216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNSEY DAWN LINDSTROM Owner 907-602-9975 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: AK 1373) |
| Enumeration Date | 2011-08-18 |
| Last Update Date | 2011-08-18 |