Organization
FAIRBANKS ORTHODONTIC GROUP, A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSICA WOLLER DMD (ORTHODONTIST)
(907) 452-2939
Entity
Organization
Contact information
Practice address
1919 LATHROP ST, SUITE 102, FAIRBANKS, AK 99701-5937
(907) 452-2939
(907) 451-7330
Mailing address
1919 LATHROP ST, SUITE 102, FAIRBANKS, AK 99701-5937
(907) 452-2939
(907) 451-7330
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
1249
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0227
—
AK
Enumeration date
06/17/2013
Last updated
06/17/2013
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us