Organization
FAMILY MEDICAL DENTAL CENTER OF ALASKA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MELEDATH GOPINATH (PRESIDENT)
(425) 869-2238
Entity
Organization
Contact information
Practice address
4361 BONIFACE PKWY, ANCHORAGE, AK 99504-4316
(907) 333-1211
(907) 333-8600
Mailing address
PO BOX 210549, ANCHORAGE, AK 99521-0549
(907) 333-1211
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
29368
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29368
STATE LICENSE
AK
Enumeration date
11/08/2006
Last updated
03/01/2012
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