Individual
DR. PHYLLIS LYNN PENDERGRAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
3539 THOMAS ST, FAIRBANKS, AK 99709
(907) 452-7041
(907) 451-7166
Mailing address
3539 THOMAS ST, FAIRBANKS, AK 99709
(907) 452-7041
(907) 451-7166
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0477
AK
Other
Enumeration date
06/18/2014
Last updated
06/26/2014
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