Individual
AIVY DAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
3024 MOUNTAIN VIEW DR STE 107, ANCHORAGE, AK 99501-3141
(907) 312-5479
Mailing address
17975 RIVERVISTA RD, EAGLE RIVER, AK 99577-9045
(989) 397-8368
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
211779
AK
1223G0001X
General Practice Dentistry
2951000871
MI
Other
Enumeration date
06/16/2021
Last updated
08/07/2023
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