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Organization
GLACIER DENTAL, LLC
Active
Organization
GLACIER DENTAL, LLC
Active
Other names
Dr. Jeon's Implant Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSHUA JEON DDS (CEO)
(907) 222-6000
Entity
Organization
Contact information
Practice address
2421 E TUDOR RD, SUITE 101, ANCHORAGE, AK 99507-1166
(907) 222-6000
(907) 333-3390
Mailing address
8840 OLD SEWARD HIGHWAY, #F, ANCHORAGE, AK 99515-2000
(907) 222-6000
(907) 333-3390
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
1239
AK
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DD2134
—
AK
Enumeration date
11/10/2009
Last updated
01/11/2022
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