Organization
FOOTHILLS DENTISTRY ALASKA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRANKLIN T WORTHAM (OWNER)
(907) 280-9585
Entity
Organization
Contact information
Practice address
4001 LAKE OTIS PKWY, SUITE 100, ANCHORAGE, AK 99508-5200
(907) 280-9585
Mailing address
4001 LAKE OTIS PKWY, SUITE 100, ANCHORAGE, AK 99508-5200
(907) 280-9585
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1024
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1582133
—
AK
Enumeration date
01/05/2013
Last updated
10/17/2016
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