Organization
VALLEY ORTHODONTICS LLC
Active
Organization
VALLEY ORTHODONTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN DAVID HARTMAN D.M.D. (OWNER/ORTHODONTIST)
(907) 376-1510
Entity
Organization
Contact information
Practice address
1001 USA CIR, WASILLA, AK 99654-7198
(907) 376-1510
Mailing address
1001 USA CIR, WASILLA, AK 99654-7198
(907) 376-1510
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
420264
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01334405
UNITED CONCORDIA PROVIDER
AK
Enumeration date
07/19/2006
Last updated
08/22/2020
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