Organization
PENINSULA DENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JUSTIN DAVID PAULSON DMD (DENTIST)
(907) 452-8296
Entity
Organization
Contact information
Practice address
47707 JUDY LYNN LANE, SOLDOTNA, AK 99669
(907) 283-9125
(907) 283-9184
Mailing address
47707 JUDY LYNN LN, SOLDONTNA, AK 99669
(907) 283-9125
(907) 283-9184
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1572
AK
Other
Enumeration date
07/24/2014
Last updated
07/24/2014
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