| Interior Community Health Center Dental Prog | |
|
1606 23rd Ave Fairbanks AK 99701-6407 | |
| (907) 455-4567 | |
| Not Available |
| Full Name | Interior Community Health Center Dental Prog |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1606 23rd Ave, Fairbanks, Alaska |
| Authorized Official Name and Position | Cheryl Kilgore (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9074554567 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Interior Community Health Center Dental Prog 1606 23rd Ave Fairbanks AK 99701-6407 Ph: (907) 455-4567 | Interior Community Health Center Dental Prog 1606 23rd Ave Fairbanks AK 99701-6407 Ph: (907) 455-4567 |
| NPI Number | 1124244181 |
|---|---|
| Provider Enumeration Date | 04/18/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124244181 | NPI | - | NPPES |
| 02-1810 | Other | AK | PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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