Organization
TIMOTHY M LETHIN DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY LETHIN DDS (OWNER)
(907) 337-9474
Entity
Organization
Contact information
Practice address
2601 BONIFACE PKWY, SUITE 2, ANCHORAGE, AK 99504-3144
(907) 337-9474
Mailing address
2601 BONIFACE PKWY, SUITE 2, ANCHORAGE, AK 99504-3144
(907) 337-9474
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1133
AK
122300000X
Dentist
1207
AK
122300000X
Dentist
213
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DDO6052
—
AK
Enumeration date
05/29/2012
Last updated
05/29/2012
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