Organization
FAIRBANKS FAMILY DENTAL CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TODD S CHRISTENSEN DDS (PRESIDENT)
(907) 452-8296
Entity
Organization
Contact information
Practice address
515 7TH AVE, SUITE 220, FAIRBANKS, AK 99701-4933
(907) 452-8296
Mailing address
515 7TH AVE, SUITE 220, FAIRBANKS, AK 99701-4933
(907) 452-8296
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DD0027
—
AK
05
—
DD0085
—
AK
Enumeration date
12/06/2012
Last updated
12/06/2012
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