Organization
TODD C MILES LLC DBA DELANEY PARK DENTAL
Active
Parent organization
DELANEY PARK DENTAL
Other names
Delaney Park Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
DELANEY PARK DENTAL
Authorized official
STACIE MICHELLE GARRABRANT (OFFICE MANAGER)
(907) 276-7787
Entity
Organization
Contact information
Practice address
880 N ST STE 301, ANCHORAGE, AK 99501-3276
(907) 276-7787
(907) 258-1685
Mailing address
880 N ST STE 301, ANCHORAGE, AK 99501-3276
(907) 276-7787
(907) 258-1685
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223P0221X
Pediatric Dentistry
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
122989
STATE LICENSE
AK
Enumeration date
09/13/2018
Last updated
09/13/2018
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