| NPI | 1912179094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WARREN THOMAS URDA Dentist 907-276-3804 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: AK 82910) |
| Enumeration Date | 2008-03-28 |
| Last Update Date | 2008-03-28 |