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Organization

NORTHERN DENTISTRY INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHARLES R. CORDOVA JR. DDS (PRESIDENT)
(702) 869-4435
Entity
Organization

Contact information

Practice address
951 E BOGARD RD, STE. #203, WASILLA, AK 99654-7175
(907) 376-2456
(907) 376-2458
Mailing address
951 E BOGARD RD, STE. #203, WASILLA, AK 99654-7175
(907) 376-2456
(907) 376-2458

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10026764
AK

Other

Enumeration date
11/23/2016
Last updated
11/23/2016
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