Individual
GWENDOLYN AGNES OWLETUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
700 CHIEF EDDIE HOFFMAN HIGHWAY, BETHEL, AK 99559-0528
(907) 679-2204
(907) 543-6399
Mailing address
PO BOX 528, BETHEL, AK 99559-0528
(907) 679-2204
(907) 543-6399
Taxonomy
Speciality
Code
Description
License number
State
125J00000X
Dental Therapist
Primary
21-159-DHAT
AK
Other
Enumeration date
08/19/2021
Last updated
08/19/2021
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