| NPI | 1962687095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALTER LEE PAYNE General Dentist 907-452-7007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AK 423) |
| Enumeration Date | 2008-01-08 |
| Last Update Date | 2008-01-08 |