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Organization

FAIRBANKS DENTAL SPECIALISTS, LLC

Active
Parent organization
SPRUCE ROOTS FAMILY DENTISTRY, LLC
Other names
Associates in Endodontics
Organization subpart
Yes

Provider details

NPI number
Legal business name
SPRUCE ROOTS FAMILY DENTISTRY, LLC
Authorized official
CHRIS WILLIS (BUSINESS MANAGER)
(907) 687-3491
Entity
Organization

Contact information

Practice address
4001 GEIST RD STE 3, FAIRBANKS, AK 99709-3569
(907) 456-3636
(907) 479-6410
Mailing address
4001 GEIST RD STE 3, FAIRBANKS, AK 99709-3569
(907) 456-3636
(907) 479-6410

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary

Other

Enumeration date
12/27/2023
Last updated
12/27/2023
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