# THAYNE DAWSON DMD LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Northwind Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518571538
- **Authorized official:** DR. THAYNE JORAY DAWSON DMD (OWNER)
- **Authorized official phone:** (907) 707-9421

## Contact information

- **Practice address:** 3719 E MERIDIAN LOOP STE B, WASILLA, AK 99654-7273
- **Practice address phone:** (907) 373-2440
- **Practice address fax:** (907) 373-1920
- **Mailing address:** 6110 N TALGACH VIEW DR, WASILLA, AK 99654-9044
- **Mailing address phone:** (208) 351-6538
- **Mailing address fax:** (907) 373-1920

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/08/2020
- **Last updated:** 07/31/2023