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Individual

ALAN VAZQUEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
4076 NEELY RD, FORT WAINWRIGHT, AK 99703
(907) 361-5172
Mailing address
4076 NEELY RD, FORT WAINWRIGHT, AK 99703
(907) 361-5172

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
11831277-9921
UT
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
242746
AK

Other

Enumeration date
08/25/2020
Last updated
10/03/2025
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