Individual
BEN T. KOLEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
851 E WESTPOINT DR STE 112, WASILLA, AK 99654-7183
(907) 376-4415
(907) 373-0589
Mailing address
851 E WESTPOINT DR, STE 112, WASILLA, AK 99654
(907) 376-4415
(907) 373-0589
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1087
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
043784444
TAX ID #
AK
05
—
DD10871
—
AK
Enumeration date
01/18/2007
Last updated
07/21/2022
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