Individual
SHARON LEE LOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CHA II
Contact information
Practice address
59 PUNGUK STREET, GOLOVIN, AK 99762
(907) 779-3311
(907) 779-3312
Mailing address
59 PUNGUK STREET, GOLOVIN, AK 99762
(907) 779-3311
(907) 779-3312
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
04-008 EFD-HA1
AK
172V00000X
Community Health Worker
Primary
CHAII
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04-008 DFT-HA1
—
AK
Enumeration date
12/14/2011
Last updated
01/06/2015
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