Organization
NORTHERN LIGHTS DENTAL ANESTHESIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENLEY DANE MICHAUD DDS (CEO)
(907) 268-3109
Entity
Organization
Contact information
Practice address
1231 W NORTHERN LIGHTS BLVD, STE 623, ANCHORAGE, AK 99503-2337
(907) 268-3109
Mailing address
205 E DIMOND BLVD # 200, ANCHORAGE, AK 99515-1909
(907) 268-3109
Taxonomy
Speciality
Code
Description
License number
State
1223D0004X
Dental Anesthesiology
Primary
1547
AK
Other
Enumeration date
08/04/2014
Last updated
08/21/2024
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