| NPI | 1912919895 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN H SUTLEY Oral Surgeon 907-452-4101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2007-08-16 |