Organization
BRIDGEVIEW DENTAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES PENFIELD DDS (OWNER)
(907) 622-7874
Entity
Organization
Contact information
Practice address
413 REZANOF DR E, KODIAK, AK 99615-6367
(907) 622-7874
(907) 622-7872
Mailing address
12641 OLD GLENN HWY STE 204, EAGLE RIVER, AK 99577
(907) 622-7874
(907) 622-7872
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1137
AK
Other
Enumeration date
02/12/2016
Last updated
02/12/2016
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