Organization
TUDOR DENTAL GROUP LLC
Active
Other names
Murphy Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SANDRA R MJOLSNES M.A. (OFFICE MANAGER)
(907) 561-4047
Entity
Organization
Contact information
Practice address
330 E TUDOR RD, ANCHORAGE, AK 99503-7369
(907) 561-4047
(907) 562-9856
Mailing address
330 E TUDOR RD, ANCHORAGE, AK 99503-7369
(907) 561-4047
(907) 562-9856
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
1131
AK
1223G0001X
General Practice Dentistry
1234
AK
1223G0001X
General Practice Dentistry
Primary
442
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000823462
UNITED CONCORDIA
AK
01
—
01630417
UNITED CONCORDIA
AK
05
—
DD1686
—
AK
05
—
DD1741
—
AK
05
—
DDO442
—
AK
Enumeration date
07/01/2009
Last updated
07/01/2009
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