| Northern Dentistry Inc. | |
|
951 E Bogard Rd Ste. #203 Wasilla AK 99654-7175 | |
| (907) 376-2456 | |
| (907) 376-2458 |
| Full Name | Northern Dentistry Inc. |
|---|---|
| Speciality | Dentist |
| Location | 951 E Bogard Rd, Wasilla, Alaska |
| Authorized Official Name and Position | Charles R. Cordova Jr. (PRESIDENT) |
| Authorized Official Contact | 7028694435 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northern Dentistry Inc. 951 E Bogard Rd Ste. #203 Wasilla AK 99654-7175 Ph: (907) 376-2456 | Northern Dentistry Inc. 951 E Bogard Rd Ste. #203 Wasilla AK 99654-7175 Ph: (907) 376-2456 |
| NPI Number | 1487197463 |
|---|---|
| Provider Enumeration Date | 11/23/2016 |
| Last Update Date | 11/23/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487197463 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 10026764 (Alaska) | Primary |
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