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Organization

PHYLLIS PENDERGRAST, D.M.D., A.P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PHYLLIS L PENDERGRAST D.M.D, (DOCTOR)
(907) 457-6145
Entity
Organization

Contact information

Practice address
3539 THOMAS ST., FAIRBANKS, AK 99709-3833
(907) 452-7041
(907) 451-7166
Mailing address
3539 THOMAS ST., FAIRBANKS, AK 99709-3833
(907) 452-7041
(907) 451-7166

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
477
AK

Other

Enumeration date
05/04/2007
Last updated
10/22/2014
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