| NPI | 1932607413 |
|---|---|
| Doing Business As | DENTAL- CHILDREN'S DENTAL CLINIC ( EAGLESOFT & DOL |
| Entity Type | Organization |
| Authorized Contact | RONALD LEE OLSON Executive Vice President Finance 907-729-4939 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2018-01-30 |
| Last Update Date | 2023-09-19 |