Organization
THOMAS B. NORDTVEDT, DDS, APC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS B. NORDTVEDT DDS (PRESIDENT)
(907) 225-8228
Entity
Organization
Contact information
Practice address
1621 TONGASS AVE, SUITE 103, KETCHIKAN, AK 99901-6013
(907) 225-8228
(907) 225-8224
Mailing address
1621 TONGASS AVE, SUITE 103, KETCHIKAN, AK 99901-6013
(907) 225-8228
(907) 225-8224
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
378
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DD0 378
—
AK
Enumeration date
10/18/2006
Last updated
08/22/2020
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