| NPI | 1902970601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATSY LEA MAY Manager 907-376-8400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AK 464) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: AK 845) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2020-08-22 |