| Jonathan Oudin, Dds, Llc | |
|
1700 E Bogard Rd Ste A201 Wasilla AK 99654-6569 | |
| (907) 373-8455 | |
| (907) 373-8456 |
| Full Name | Jonathan Oudin, Dds, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1700 E Bogard Rd Ste A201, Wasilla, Alaska |
| Authorized Official Name and Position | Jonathan Oudin (OWNER) |
| Authorized Official Contact | 2143170521 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jonathan Oudin, Dds, Llc 1700 E Bogard Rd Ste A201 Wasilla AK 99654-6569 Ph: (907) 373-8455 | Jonathan Oudin, Dds, Llc 1700 E Bogard Rd Ste A201 Wasilla AK 99654-6569 Ph: (907) 373-8455 |
| NPI Number | 1265167522 |
|---|---|
| Provider Enumeration Date | 07/20/2022 |
| Last Update Date | 07/20/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265167522 | NPI | - | NPPES |
| 1574946 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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