| NPI | 1942476015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NEWELL A WALTHER Owner 907-376-9449 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AK 1038) |
| Additional Taxonomies | 122300000X Dentist (Licence: AK 1566) |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2016-04-21 |