| Cook Inlet Dental | |
|
908 Highland Ave Ste 2 Kenai AK 99611-8051 | |
| (907) 283-0454 | |
| (907) 283-0456 |
| Full Name | Cook Inlet Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 908 Highland Ave Ste 2, Kenai, Alaska |
| Authorized Official Name and Position | James W Halliday (DENTIST) |
| Authorized Official Contact | 9072830454 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cook Inlet Dental 908 Highland Ave Ste 1 Kenai AK 99611-8051 Ph: (907) 283-0454 | Cook Inlet Dental 908 Highland Ave Ste 2 Kenai AK 99611-8051 Ph: (907) 283-0454 |
| NPI Number | 1699080432 |
|---|---|
| Provider Enumeration Date | 08/17/2010 |
| Last Update Date | 08/17/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699080432 | NPI | - | NPPES |
| DD9411 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | D1148 (Alaska) | Primary |
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