Organization
JONATHAN OUDIN, DDS, LLC
Active
Other names
Alaska Center for Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN OUDIN DDS (OWNER)
(214) 317-0521
Entity
Organization
Contact information
Practice address
1700 E BOGARD RD STE A201, WASILLA, AK 99654-6569
(907) 373-8455
(907) 373-8456
Mailing address
1700 E BOGARD RD STE A201, WASILLA, AK 99654-6569
(907) 373-8455
(907) 373-8456
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1574946
—
AK
Enumeration date
07/20/2022
Last updated
07/20/2022
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