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Organization

EAGLE SUMMIT DENTAL GROUP

Active
Other names
Michael Sanders DMD PC
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHAEL ROLAND SANDERS DMD (PRESIDENT)
(907) 694-8234
Entity
Organization

Contact information

Practice address
13015 OLD GLENN HWY, #200, EAGLE RIVER, AK 99577
(907) 694-8234
(907) 697-8225
Mailing address
13015 OLD GLENN HWY, #200, EAGLE RIVER, AK 99577-8080
(907) 694-8234
(907) 697-8225

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1086
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1086
STATE LICENSE
AK
Enumeration date
12/19/2008
Last updated
11/25/2014
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