Organization
ARCTIC SLOPE NATIVE ASSOCIATION
Active
Other names
Samuel Simmonds Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMANDA ASHLEY-GAYNOR DMD (CLINICAL DIRECTOR OF DENTAL)
(907) 852-4611
Entity
Organization
Contact information
Practice address
1296 AGVIK ST, BARROW, AK 99723
(907) 852-4611
(907) 852-9297
Mailing address
PO BOX 29, 1296 AGVIK ST, BARROW, AK 99723-0029
(907) 852-4611
(907) 852-9297
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DD1010
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DD1010
—
AK
Enumeration date
04/09/2007
Last updated
08/22/2020
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