Organization
GLACIER DENTAL, LLC
Active
Other names
Dr. Jeon's Implant Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSHUA JEON DDS (CEO)
(907) 222-6000
Entity
Organization
Contact information
Practice address
2421 E TUDOR RD, SUITE 101, ANCHORAGE, AK 99507-1166
(907) 222-6000
(907) 333-3390
Mailing address
8840 OLD SEWARD HIGHWAY, #F, ANCHORAGE, AK 99515-2000
(907) 222-6000
(907) 333-3390
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
1239
AK
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DD2134
—
AK
Enumeration date
11/10/2009
Last updated
01/11/2022
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