| Dental- Pedro Bay Dental Clinic | |
|
2516 Mountain Circle Pedro Bay AK 99647 | |
| (907) 850-2229 | |
| Not Available |
| Full Name | Dental- Pedro Bay Dental Clinic |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2516 Mountain Circle, Pedro Bay, Alaska |
| Authorized Official Name and Position | Ronald Lee Olson (EXECUTIVE VICE PRESIDENT FINANCE) |
| Authorized Official Contact | 9077294939 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental- Pedro Bay Dental Clinic Po Box 35151 Seattle WA 98124-5151 Ph: () - | Dental- Pedro Bay Dental Clinic 2516 Mountain Circle Pedro Bay AK 99647 Ph: (907) 850-2229 |
| NPI Number | 1144777046 |
|---|---|
| Provider Enumeration Date | 09/08/2016 |
| Last Update Date | 09/01/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144777046 | NPI | - | NPPES |
| 1654571 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 20467 (Alaska) | Primary |