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Organization
FAIRBANKS DENTAL CENTER LLC
Active
Organization
FAIRBANKS DENTAL CENTER LLC
Active
Other names
Fairbanks Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL JOHN STOLTZ DMD (PARTNER)
(907) 452-1250
Entity
Organization
Contact information
Practice address
3112 AIRPORT WAY, SUITE 1, FAIRBANKS, AK 99709-4768
(907) 452-1250
(907) 456-1307
Mailing address
3112 AIRPORT WAY, SUITE 1, FAIRBANKS, AK 99709-4768
(907) 452-1250
(907) 456-1307
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223X2210X
Orofacial Pain Dentistry
—
—
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
03/08/2016
Last updated
11/03/2023
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