Organization
PREVENTIVE DENTAL SERVICES, A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN JEANNE POLIS D.D.S. , R.D.H (DENTIST)
(907) 235-1286
Entity
Organization
Contact information
Practice address
549 GRUBSTAKE AVE, SUITE #A, HOMER, AK 99603-7640
(907) 235-1286
(907) 235-1263
Mailing address
549 GRUBSTAKE AVE, SUITE #A, HOMER, AK 99603-7640
(907) 235-1286
(907) 235-1263
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
03/29/2013
Last updated
03/29/2013
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