Organization
ACD, LLC
Active
Parent organization
-
Other names
Aurora Children's Dentistry
Organization subpart
Yes
Provider details
NPI number
Legal business name
-
Authorized official
MARK JAMES MCLEAN DMD (PRESIDENT)
(907) 336-1234
Entity
Organization
Contact information
Practice address
3340 PROVIDENCE DR., SUITE 552, ANCHORAGE, AK 99508
(907) 336-1234
(907) 336-4321
Mailing address
3340 PROVIDENCE DR STE 552, ANCHORAGE, AK 99508-4643
(907) 336-1234
(907) 336-4321
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
10064075
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0888
DENTIST
AK
Enumeration date
08/24/2017
Last updated
07/21/2022
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