Individual
DR. KENNETH D OLDHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
3650 LAKE OTIS PKWY, SUITE 102, ANCHORAGE, AK 99508-5207
(907) 563-5820
(907) 562-7029
Mailing address
3650 LAKE OTIS PKWY, SUITE 102, ANCHORAGE, AK 99508-5207
(907) 563-5820
(907) 562-7029
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
AA707
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DD7070
—
AK
Enumeration date
04/23/2007
Last updated
07/08/2007
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