Individual
DR. JONATHAN ROBERT OUDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1700 E BOGARD RD STE A201, WASILLA, AK 99654-6569
(907) 373-8455
(907) 373-8456
Mailing address
1700 E BOGARD RD STE A201, WASILLA, AK 99654-6569
(907) 373-8455
(907) 373-8456
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
1390
AK
122300000X
Dentist
25644
TX
1223G0001X
General Practice Dentistry
Primary
DEND1390
AK
Other
Enumeration date
08/04/2011
Last updated
07/20/2022
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