Samuel Simmonds Dental | |
1296 Agvik St Barrow AK 99723 | |
(907) 852-4611 | |
(907) 852-9297 |
Full Name | Samuel Simmonds Dental |
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Speciality | Clinic/center - Dental |
Location | 1296 Agvik St, Barrow, Alaska |
Authorized Official Name and Position | Amanda Ashley-gaynor (CLINICAL DIRECTOR OF DENTAL) |
Authorized Official Contact | 9078524611 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Samuel Simmonds Dental Po Box 29 1296 Agvik St Barrow AK 99723-0029 Ph: (907) 852-4611 | Samuel Simmonds Dental 1296 Agvik St Barrow AK 99723 Ph: (907) 852-4611 |
NPI Number | 1528181971 |
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Provider Enumeration Date | 04/09/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1528181971 | NPI | - | NPPES |
DD1010 | Medicaid | AK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | DD1010 (Alaska) | Primary |