Organization
FAIRBANKS DENTAL CENTER LLC
Active
Other names
Fairbanks Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL JOHN STOLTZ DMD (PARTNER)
(907) 452-1250
Entity
Organization
Contact information
Practice address
3112 AIRPORT WAY, SUITE 1, FAIRBANKS, AK 99709-4768
(907) 452-1250
(907) 456-1307
Mailing address
3112 AIRPORT WAY, SUITE 1, FAIRBANKS, AK 99709-4768
(907) 452-1250
(907) 456-1307
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223X2210X
Orofacial Pain Dentistry
—
—
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
03/08/2016
Last updated
11/03/2023
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