Organization
SUMMIT ORAL SURGERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW ANTHONY WELCH DDS (MEMBER)
(907) 357-3414
Entity
Organization
Contact information
Practice address
1700 E BOGARD RD STE B202, WASILLA, AK 99654-6570
(907) 357-3414
(907) 357-3714
Mailing address
1700 E BOGARD RD STE B202, WASILLA, AK 99654-6570
(907) 357-3414
(907) 357-3714
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
1159
AK
Other
Enumeration date
01/10/2008
Last updated
01/10/2008
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