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Organization
SOUTHEAST ALASKA REGIONAL HEALTH CONSORTIUM
Active
Organization
SOUTHEAST ALASKA REGIONAL HEALTH CONSORTIUM
Active
Other names
SEARHC AICS Dental, SEARHC WRANGELL DENTAL CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL HARRIS (VP/CHIEF FINANCIAL OFFICER)
(907) 463-4000
Entity
Organization
Contact information
Practice address
215 FRONT ST, WRANGELL, AK 99929
(907) 874-3731
(907) 874-3531
Mailing address
3100 CHANNEL DRIVE STE 300, ATTN: PROVIDER ENROLLMENT, JUNEAU, AK 99801
(907) 463-4000
(907) 463-1510
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1663271
—
AK
01
—
70206
BUSINESS LICENSE
AK
Enumeration date
01/06/2017
Last updated
12/29/2020
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