Individual
MRS. JILL MARIE KISAKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
222 TONGASS DR, ATTN: JILL KISAKA IN DENTAL, SITKA, AK 99835-9416
(907) 966-2411
(907) 966-8663
Mailing address
222 TONGASS DR, ATTN: JILL KISAKA IN DENTAL, SITKA, AK 99835-9416
(907) 966-2411
(907) 966-8663
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2027
AK
124Q00000X
Dental Hygienist
DH 60100153
WA
Other
Enumeration date
04/23/2012
Last updated
04/23/2012
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