Organization
LAKEVIEW PROFESSIONAL DENTAL ASSOCIATES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEAN KINGSLIEN (DIRECTOR SECRETARY TREASURER)
(907) 346-2625
Entity
Organization
Contact information
Practice address
851 WESTPOINT DR, SUITE 112, WASILLA, AK 99654-7142
(907) 376-4415
(907) 373-0589
Mailing address
851 WESTPOINT DR, SUITE 112, WASILLA, AK 99654-7142
(907) 376-4415
(907) 373-0589
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
348
AK
Other
Enumeration date
03/01/2007
Last updated
08/22/2020
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