Organization
REX C. MALCOM PHARMD DMD, LLC
Active
Other names
Alaska Advanced Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REX MALCOM DMD (MANAGER)
(907) 522-3633
Entity
Organization
Contact information
Practice address
6917 OLD SEWARD HWY, ANCHORAGE, AK 99518-2276
(907) 522-3633
Mailing address
6917 OLD SEWARD HWY, ANCHORAGE, AK 99518-2276
(907) 522-3633
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
100531
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1642221
—
AK
Enumeration date
05/09/2018
Last updated
05/09/2018
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