Individual
LANDON MOMBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDM
Contact information
Practice address
1000 GREG KRUSCHEK AVE, NOME, AK 99762-0966
(907) 443-3311
Mailing address
PO BOX 966, NOME, AK 99762-0966
(907) 443-3309
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DEN.00203726
CO
Other
Enumeration date
08/06/2018
Last updated
08/19/2020
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