| Fairbanks Orthodontic Group A Prof Corp | |
|
1919 Lathrop St Suite 102 Fairbanks AK 99701 | |
| (907) 452-2939 | |
| (907) 451-7330 |
| Full Name | Fairbanks Orthodontic Group A Prof Corp |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 1919 Lathrop St, Fairbanks, Alaska |
| Authorized Official Name and Position | Walt Babula (PRESIDENT ORTHODONTIST) |
| Authorized Official Contact | 9074522939 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fairbanks Orthodontic Group A Prof Corp 1919 Lathrop St Suite 102 Fairbanks AK 99701 Ph: (907) 452-2939 | Fairbanks Orthodontic Group A Prof Corp 1919 Lathrop St Suite 102 Fairbanks AK 99701 Ph: (907) 452-2939 |
| NPI Number | 1013084680 |
|---|---|
| Provider Enumeration Date | 11/29/2006 |
| Last Update Date | 08/07/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013084680 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | AK330 (Alaska) | Secondary |
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | AK9 (Alaska) | Primary |
Spruce Roots Family Dentistry, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 4001 Geist Rd, Ste 5, Fairbanks, AK 99709 Phone: 907-479-3326 Fax: 907-479-6410 | |
Young Smiles Children's Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 114 Minnie St, Suite A, Fairbanks, AK 99701 Phone: 907-452-4509 | |
Interior Community Health Center Dental Prog Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1606 23rd Ave, Fairbanks, AK 99701 Phone: 907-455-4567 | |
Spruce Roots Family Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 4001 Geist Rd, Ste 5b, Fairbanks, AK 99709 Phone: 907-479-3326 | |
North Star Children's Dentistry, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 114 Minnie St, Suite A, Fairbanks, AK 99701 Phone: 907-452-4509 Fax: 907-457-4509 | |
Fairbanks Dental Specialists, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 4001 Geist Rd Ste 3, Fairbanks, AK 99709 Phone: 907-456-3636 Fax: 907-479-6410 |