Organization
MAT-SU DENTAL CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSANNE KENNARD (CEO)
(907) 376-2456
Entity
Organization
Contact information
Practice address
951 BOGARD RD, SUITE 203, WASILLA, AK 99654-7113
(907) 376-2456
(907) 376-2458
Mailing address
951 BOGARD RD, SUITE 203, WASILLA, AK 99654-7113
(907) 376-2456
(907) 376-2458
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
285249
AK
Other
Enumeration date
04/25/2007
Last updated
08/22/2020
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