| Foothills Dentistry Alaska, Llc | |
|
4001 Lake Otis Pkwy Suite 100 Anchorage AK 99508-5200 | |
| (907) 280-9585 | |
| Not Available |
| Full Name | Foothills Dentistry Alaska, Llc |
|---|---|
| Speciality | Dentist |
| Location | 4001 Lake Otis Pkwy, Anchorage, Alaska |
| Authorized Official Name and Position | Franklin T Wortham (OWNER) |
| Authorized Official Contact | 9072809585 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Foothills Dentistry Alaska, Llc 4001 Lake Otis Pkwy Suite 100 Anchorage AK 99508-5200 Ph: (907) 280-9585 | Foothills Dentistry Alaska, Llc 4001 Lake Otis Pkwy Suite 100 Anchorage AK 99508-5200 Ph: (907) 280-9585 |
| NPI Number | 1639416001 |
|---|---|
| Provider Enumeration Date | 01/05/2013 |
| Last Update Date | 10/17/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639416001 | NPI | - | NPPES |
| 1582133 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 1024 (Alaska) | Primary |
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