| Fairbanks Orthodontic Group, A Professional Corporation | |
|
1919 Lathrop St Suite 102 Fairbanks AK 99701-5937 | |
| (907) 452-2939 | |
| (907) 451-7330 |
| Full Name | Fairbanks Orthodontic Group, A Professional Corporation |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1919 Lathrop St, Fairbanks, Alaska |
| Authorized Official Name and Position | Jessica Woller (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 Professional Corporation 1919 Lathrop St Suite 102 Fairbanks AK 99701-5937 Ph: (907) 452-2939 | Fairbanks Orthodontic Group, A Professional Corporation 1919 Lathrop St Suite 102 Fairbanks AK 99701-5937 Ph: (907) 452-2939 |
| NPI Number | 1376982918 |
|---|---|
| Provider Enumeration Date | 06/17/2013 |
| Last Update Date | 06/17/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376982918 | NPI | - | NPPES |
| GR0227 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 1249 (Alaska) | Primary |
Fairbanks Orthodontic Group A Prof Corp Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1919 Lathrop St, Suite 102, Fairbanks, AK 99701 Phone: 907-452-2939 Fax: 907-451-7330 | |
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 |