Individual
DR. SUSAN JEANNE POLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
549 GRUBSTAKE AVE, SUITE A, HOMER, AK 99603-7640
(907) 235-1286
(907) 235-1263
Mailing address
549 GRUBSTAKE AVE, SUITE A, HOMER, AK 99603-7640
(907) 235-1286
(907) 235-1263
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
935
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D951
—
AK
Enumeration date
02/26/2007
Last updated
07/08/2007
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