Organization
AESTHETIC FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT ALLEN METHVEN D.D.S (OWNER)
(907) 357-6684
Entity
Organization
Contact information
Practice address
1551 W PARKS HWY, WASILLA, AK 99654-6933
(907) 357-6684
(907) 357-6964
Mailing address
1551 W PARKS HWY, WASILLA, AK 99654-6933
(907) 357-6684
(907) 357-6964
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1054
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DD6231
—
AK
Enumeration date
03/06/2009
Last updated
03/06/2009
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