| Alaska Dental Outreach Consortium | |
|
9170 Jewel Lake Rd Ste 203 Anchorage AK 99502-5390 | |
| (907) 563-3011 | |
| (907) 563-3009 |
| Full Name | Alaska Dental Outreach Consortium |
|---|---|
| Speciality | Dentist |
| Location | 9170 Jewel Lake Rd Ste 203, Anchorage, Alaska |
| Authorized Official Name and Position | James Richard Towle (SECRETARY OF THE BOARD OF DIRECTORS) |
| Authorized Official Contact | 9075633011 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alaska Dental Outreach Consortium 9170 Jewel Lake Rd Ste 203 Anchorage AK 99502-5390 Ph: (907) 563-3011 | Alaska Dental Outreach Consortium 9170 Jewel Lake Rd Ste 203 Anchorage AK 99502-5390 Ph: (907) 563-3011 |
| NPI Number | 1356677751 |
|---|---|
| Provider Enumeration Date | 10/20/2009 |
| Last Update Date | 10/20/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356677751 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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