| Dental- St Paul Dental Clinic | |
|
1000 Polovina Turnpike St Paul AK 99660 | |
| (907) 546-8300 | |
| Not Available |
| Full Name | Dental- St Paul Dental Clinic |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1000 Polovina Turnpike, St Paul, 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- St Paul Dental Clinic Po Box 35151 Seattle WA 98124-5151 Ph: () - | Dental- St Paul Dental Clinic 1000 Polovina Turnpike St Paul AK 99660 Ph: (907) 546-8300 |
| NPI Number | 1922555820 |
|---|---|
| Provider Enumeration Date | 09/08/2016 |
| Last Update Date | 09/18/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922555820 | NPI | - | NPPES |
| 1654581 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 20467 (Alaska) | Primary |