| 49th State Family Dentistry Llc | |
|
10998 Omalley Centre Dr Ste A Anchorage AK 99515-3168 | |
| (907) 561-5154 | |
| (907) 561-2253 |
| Full Name | 49th State Family Dentistry Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 10998 Omalley Centre Dr Ste A, Anchorage, Alaska |
| Authorized Official Name and Position | Ellen Donohue (OWNER/MEMBER) |
| Authorized Official Contact | 9075615154 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 49th State Family Dentistry Llc 10998 Omalley Centre Dr Ste A Anchorage AK 99515-3168 Ph: (907) 561-5154 | 49th State Family Dentistry Llc 10998 Omalley Centre Dr Ste A Anchorage AK 99515-3168 Ph: (907) 561-5154 |
| NPI Number | 1669065132 |
|---|---|
| Provider Enumeration Date | 02/16/2021 |
| Last Update Date | 02/16/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669065132 | NPI | - | NPPES |
| 1114268711 | Other | TYPE 1 NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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