Organization
JAMES BOURNE DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES RANDALL BOURNE DDS (OWNER)
(907) 235-8574
Entity
Organization
Contact information
Practice address
3732 BEN WALTERS LN, HOMER, AK 99603-7704
(907) 235-8574
(907) 235-7593
Mailing address
3732 BEN WALTERS LN, HOMER, AK 99603-7704
(907) 235-8574
(907) 235-7593
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
AK1516
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1598094
—
AK
Enumeration date
07/27/2015
Last updated
07/27/2015
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