Individual
THOMAS KOVALESKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4201 TUDOR CENTRE DR, SUITE 320, ANCHORAGE, AK 99508-5904
(907) 317-6070
(806) 794-1919
Mailing address
4501 DIPLOMACY DRIVE, ATTN: FINANCE/PROVIDER ENROLLMENT, ANCHORAGE, AK 99508-5919
(907) 729-2000
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DEND737
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
833966
UNITED CONCORDIA
—
05
—
DD0737
—
AK
Enumeration date
07/17/2006
Last updated
10/23/2015
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