Organization
ALASKA COSMEDIC DENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSE G HRONKIN DMD (OWNER)
(907) 373-2232
Entity
Organization
Contact information
Practice address
936 E WESTPOINT DRIVE, WASILLA, AK 99654
(907) 373-2232
(907) 373-2439
Mailing address
936 E WESTPOINT DRIVE, WASILLA, AK 99654
(907) 373-2232
(907) 373-2439
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1123
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1702599
UNITED CONCORDIA TRICARE
—
01
—
DD11231
DENAL KID CARE
AK
Enumeration date
08/26/2006
Last updated
08/22/2020
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