Organization
PENINSULA DENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN SELDEN (PRESIDENT)
(907) 283-9125
Entity
Organization
Contact information
Practice address
47707 JUDY LYNN LANE, SOLDOTNA, AK 99669
(907) 283-9125
Mailing address
PO BOX 2710, SOLDOTNA, AK 99669-2710
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
877
AK
Other
Enumeration date
06/07/2011
Last updated
06/07/2011
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