Individual
DR. HANS PATRICK NORDSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1001 E USA CIR, SUITE B, WASILLA, AK 99654-7198
(907) 357-6800
(907) 357-6878
Mailing address
1001 E USA CIR, SUITE B, WASILLA, AK 99654-7198
(907) 357-6800
(907) 357-6878
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1135
AK
1223G0001X
General Practice Dentistry
1135
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0053521
—
AK
01
—
01634756
TRICARE
AK
Enumeration date
07/17/2006
Last updated
10/21/2008
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