Individual
DR. JEREMY SCOTT SORHUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
120 TRADING BAY RD., #280, KENAI, AK 99611-7781
(907) 335-0363
(907) 335-0364
Mailing address
120 TRADING BAY RD., #280, KENAI, AK 99611-7781
(907) 335-0363
(907) 335-0364
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DEND1380
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000021444
BLUE CROSS BLUE SHIELD ID
MT
01
—
01620902
UNITED CONCORDIA ID
MT
05
—
1573802
—
AK
Enumeration date
12/12/2006
Last updated
12/12/2024
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