Organization
HANS P. NORDSTROM DDS
Active
Other names
Nordstrom Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
HANS P NORDSTROM DDS (OWNER)
(907) 357-6800
Entity
Organization
Contact information
Practice address
1001 E. USA CIRCLE, SUITE B, WASILLA, AK 99654-7198
(907) 357-6800
Mailing address
1001 E. USA CIRCLE, SUITE B, WASILLA, AK 99654-7198
(907) 357-6800
(907) 357-6878
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1135
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01634756
UNITED CONCORDIA
—
05
—
DD53521
—
AK
Enumeration date
04/01/2009
Last updated
04/01/2009
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