Organization
ALASKA PREMIER DENTAL GROUP WASILLA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENDALL SKINNER (OWNER)
(907) 337-0404
Entity
Organization
Contact information
Practice address
935 E WESTPOINT DR, SUITE 202, WASILLA, AK 99654-7143
(907) 373-5930
Mailing address
6611 DEBARR RD, SUITE 200, ANCHORAGE, AK 99504-1706
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
111306
AK
Other
Enumeration date
10/01/2007
Last updated
10/01/2007
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