| NPI | 1952482572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS B. NORDTVEDT President 907-225-8228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AK 378) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2020-08-22 |