Individual
KELLY MOPANGGA ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
4000 OLD SEWARD HWY STE 200, ANCHORAGE, AK 99503-6068
(907) 561-3639
Mailing address
26125 WILDFLOWER CIR, EAGLE RIVER, AK 99577-9678
(907) 782-9002
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
210133
AK
Other
Enumeration date
08/14/2023
Last updated
08/14/2023
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