| Phyllis Pendergrast, D.m.d., A.p.c. | |
|
3539 Thomas St. Fairbanks AK 99709-3833 | |
| (907) 452-7041 | |
| (907) 451-7166 |
| Full Name | Phyllis Pendergrast, D.m.d., A.p.c. |
|---|---|
| Speciality | Dentist |
| Location | 3539 Thomas St., Fairbanks, Alaska |
| Authorized Official Name and Position | Phyllis L Pendergrast (DOCTOR) |
| Authorized Official Contact | 9074576145 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Phyllis Pendergrast, D.m.d., A.p.c. 3539 Thomas St. Fairbanks AK 99709-3833 Ph: (907) 452-7041 | Phyllis Pendergrast, D.m.d., A.p.c. 3539 Thomas St. Fairbanks AK 99709-3833 Ph: (907) 452-7041 |
| NPI Number | 1639381429 |
|---|---|
| Provider Enumeration Date | 05/04/2007 |
| Last Update Date | 10/22/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639381429 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 477 (Alaska) | Primary |
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