| Mat-su Dental Center, Inc. | |
|
951 Bogard Rd Suite 203 Wasilla AK 99654-7113 | |
| (907) 376-2456 | |
| (907) 376-2458 |
| Full Name | Mat-su Dental Center, Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 951 Bogard Rd, Wasilla, Alaska |
| Authorized Official Name and Position | Susanne Kennard (CEO) |
| Authorized Official Contact | 9073762456 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mat-su Dental Center, Inc. 951 Bogard Rd Suite 203 Wasilla AK 99654-7113 Ph: (907) 376-2456 | Mat-su Dental Center, Inc. 951 Bogard Rd Suite 203 Wasilla AK 99654-7113 Ph: (907) 376-2456 |
| NPI Number | 1417177346 |
|---|---|
| Provider Enumeration Date | 04/25/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417177346 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 285249 (Alaska) | Primary |
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