| Walther Dental Inc | |
|
1700 E Bogard Rd Bldg B Wasilla AK 99654-6563 | |
| (907) 376-9449 | |
| (907) 376-9339 |
| Full Name | Walther Dental Inc |
|---|---|
| Speciality | Dentist |
| Location | 1700 E Bogard Rd Bldg B, Wasilla, Alaska |
| Authorized Official Name and Position | Newell A Walther (OWNER) |
| Authorized Official Contact | 9073769449 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Walther Dental Inc 1700 E Bogard Rd Ste B204 Wasilla AK 99654-6570 Ph: (907) 376-9449 | Walther Dental Inc 1700 E Bogard Rd Bldg B Wasilla AK 99654-6563 Ph: (907) 376-9449 |
| NPI Number | 1942476015 |
|---|---|
| Provider Enumeration Date | 05/07/2008 |
| Last Update Date | 04/21/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942476015 | NPI | - | NPPES |
| 1612641 | Medicaid | AK | |
| 1003444 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 1038 (Alaska) | Primary |
| 122300000X | Dentist | 1566 (Alaska) | Secondary |
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